Healthcare Provider Details

I. General information

NPI: 1518108927
Provider Name (Legal Business Name): ANTHEM CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2009
Last Update Date: 03/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10170 S EASTERN AVE STE 110
HENDERSON NV
89052-3969
US

IV. Provider business mailing address

10170 S EASTERN AVE STE 110
HENDERSON NV
89052-3969
US

V. Phone/Fax

Practice location:
  • Phone: 702-614-6777
  • Fax: 702-614-6778
Mailing address:
  • Phone: 702-614-6777
  • Fax: 702-614-6778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberB00660
License Number StateNV

VIII. Authorized Official

Name: DR. DEREK T DAY
Title or Position: PRESIDENT
Credential: D.C.
Phone: 702-614-6777