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General NPI Number Information
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NPI Number | 1154942050
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Entity Type | Organization
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Legal Business Name | LUXIAM CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/01/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 230 W PLUMB LN
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City | RENO
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State | NV
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Zip | 89509-3748
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Country | US
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Telephone | 775-746-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 3005 ETHELINDA WAY
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City | RENO
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State | NV
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Zip | 89521-4426
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Country | US
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Telephone | 775-220-2133
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LAUREN SMITH
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Credential | LCSW
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Telephone | 775-220-2133
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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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