Healthcare Provider Details

I. General information

NPI: 1649279365
Provider Name (Legal Business Name): ALAN S BADER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 E MOANA LN STE 28
RENO NV
89502-4641
US

IV. Provider business mailing address

294 E MOANA LN STE 28
RENO NV
89502-4641
US

V. Phone/Fax

Practice location:
  • Phone: 775-829-7575
  • Fax: 775-829-7755
Mailing address:
  • Phone: 775-829-7575
  • Fax: 775-829-7755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number-B-567
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: