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NPI Code Detail

MEDICARE: BURKE SPINAL CARE, LTD

MEDICARE: BURKE SPINAL CARE, LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorB00447NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1841323326
Entity Type Code : Organization
Provider Name (Legal Business Name) : BURKE SPINAL CARE, LTD
Provider Business Mailing Address
First Line : 7240 W LAKE MEAD BLVD
Second Line : SUITE 3
City : LAS VEGAS
State : NV
Zip : 89128-8356
Country : US
Telephone Number : 702-453-0440
Fax Number : 702-453-0550
Provider Business Practice Location Address
First Line : 7240 W LAKE MEAD BLVD
Second Line : SUITE 3
City : LAS VEGAS
State : NV
Zip : 89128-8356
Country : US
Telephone Number : 702-453-0440
Fax Number : 702-453-0550
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. CAMERON MITCHELL DUDLEY
Credential : D.C.
Telephone Number : 702-453-0440
Provider Enumeration Date : 03/13/2007
Last Update Date : 11/14/2007

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Directions to “BURKE SPINAL CARE, LTD ” Practice Location

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