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General NPI Number Information
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NPI Number | 1053926253
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Entity Type | Organization
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Legal Business Name | KOEVEN CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 1724 C ST
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City | SPARKS
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State | NV
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Zip | 89431-4874
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Country | US
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Telephone | 775-525-1484
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Fax | 775-451-9504
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Provider Business Mailing Address
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Address Line | 705 TODD CT
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City | FERNLEY
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State | NV
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Zip | 89408-7558
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Country | US
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Telephone | 775-525-1484
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Fax | 775-451-9504
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Authorized Official
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Title or Position | MANAGER / OWNER
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Name | DR. CHRIS KOEVEN
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Credential | DC
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Telephone | 775-525-1484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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