Healthcare Provider Details

I. General information

NPI: 1841784766
Provider Name (Legal Business Name): MELISSA HOBAICA DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2275 N GREEN VALLEY PKWY
HENDERSON NV
89014-5025
US

IV. Provider business mailing address

2275 N GREEN VALLEY PKWY
HENDERSON NV
89014-5025
US

V. Phone/Fax

Practice location:
  • Phone: 702-435-0808
  • Fax: 702-435-0818
Mailing address:
  • Phone: 702-435-0808
  • Fax: 702-435-0818

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01785
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104557497
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: