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NPI Code Detail

MEDICARE: KEITH LEONARD QUISBERG D.C.

MEDICARE: KEITH LEONARD QUISBERG D.C.
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
1111N00000XChiropractorB0993NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1156422OTHERNVSUMMERLIN HEALTH & LIFE

General Provider Information

NPI Number : 1881778199
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH LEONARD QUISBERG D.C.
Provider Business Mailing Address
First Line : 6441 N DURANGO DR STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-4588
Country : US
Telephone Number : 702-538-9100
Fax Number : 702-478-6013
Provider Business Practice Location Address
First Line : 6441 N DURANGO DR STE 130
Second Line :
City : LAS VEGAS
State : NV
Zip : 89149-4588
Country : US
Telephone Number : 702-538-9100
Fax Number : 702-478-6013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2006
Last Update Date : 08/05/2013

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Directions to “ KEITH LEONARD QUISBERG D.C.” Practice Location

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