MEDICARE: JUSTIN GOLDSTEIN DC

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	B01468	NV

General Provider Information

NPI Number	:	1902155831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUSTIN GOLDSTEIN DC

Provider Business Mailing Address
First Line	:	9484 W FLAMINGO RD
Second Line	:	SUITE 160
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-5744
Country	:	US
Telephone Number	:	702-997-6063
Fax Number	:	702-910-4512

Provider Business Practice Location Address
First Line	:	9484 W FLAMINGO RD
Second Line	:	SUITE 160
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-5744
Country	:	US
Telephone Number	:	702-997-6063
Fax Number	:	702-910-4512

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

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	09/29/2014

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Directions to “ JUSTIN GOLDSTEIN DC” Practice Location

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