Healthcare Provider Details

I. General information

NPI: 1760488084
Provider Name (Legal Business Name): ARNOLD C. JOVILLAR D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 07/27/2022
Certification Date: 07/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N PECOS RD
N LAS VEGAS NV
89086-4400
US

IV. Provider business mailing address

6900 N PECOS RD
N LAS VEGAS NV
89086-4400
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9000
  • Fax:
Mailing address:
  • Phone: 702-917-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberB01313
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC25296
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: