MEDICARE: DR. BRIAN DOUGLAS ROGERS 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
1	111N00000X	Chiropractor	B01303	NV

General Provider Information

NPI Number	:	1902057854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN DOUGLAS ROGERS D.C.

Provider Business Mailing Address
First Line	:	200 E HORIZON DR
Second Line	:	SUITE A
City	:	HENDERSON
State	:	NV
Zip	:	89015-8033
Country	:	US
Telephone Number	:	702-568-8450
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E HORIZON DR
Second Line	:	SUITE A
City	:	HENDERSON
State	:	NV
Zip	:	89015-8033
Country	:	US
Telephone Number	:	702-568-8450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2008
Last Update Date	:	11/15/2012

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