Healthcare Provider Details

I. General information

NPI: 1356826440
Provider Name (Legal Business Name): LES DANIEL GILBERT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1698 COUNTY RD
MINDEN NV
89423-4405
US

IV. Provider business mailing address

1698 COUNTY RD
MINDEN NV
89423-4405
US

V. Phone/Fax

Practice location:
  • Phone: 702-478-9594
  • Fax: 702-478-9509
Mailing address:
  • Phone: 702-396-4993
  • Fax: 702-636-4990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberB01688
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: