Healthcare Provider Details

I. General information

NPI: 1053529347
Provider Name (Legal Business Name): JEFFREY L WEBB D.C., DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1928 E SAHARA AVE
LAS VEGAS NV
89104-3843
US

IV. Provider business mailing address

4616 W SAHARA AVE # 337
LAS VEGAS NV
89102-3654
US

V. Phone/Fax

Practice location:
  • Phone: 702-457-4727
  • Fax: 702-457-7083
Mailing address:
  • Phone: 702-880-4193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number3001
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB00424
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: