Healthcare Provider Details

I. General information

NPI: 1598747644
Provider Name (Legal Business Name): PAUL ROBERT PIRRUCCELLO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2005
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3670 GRANT DR SUITE 101
RENO NV
89509-5309
US

IV. Provider business mailing address

3670 GRANT DR SUITE 101
RENO NV
89509-5309
US

V. Phone/Fax

Practice location:
  • Phone: 775-852-3333
  • Fax: 775-322-0606
Mailing address:
  • Phone: 775-852-3333
  • Fax: 775-322-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License NumberB282
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: