Healthcare Provider Details

I. General information

NPI: 1407524713
Provider Name (Legal Business Name): CHAD BASINGER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2021
Last Update Date: 09/01/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2779 W HORIZON RIDGE PKWY STE 210
HENDERSON NV
89052-4186
US

IV. Provider business mailing address

701 ASPEN PEAK LOOP APT 3623
HENDERSON NV
89011-1851
US

V. Phone/Fax

Practice location:
  • Phone: 702-948-2520
  • Fax:
Mailing address:
  • Phone: 801-687-6924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01891
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: