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General NPI Number Information
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NPI Number | 1437476280
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Entity Type | Organization
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Legal Business Name | DR. BRIAN K. FIFE, INC
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Dates
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Enumeration Date | 05/03/2010
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Last Update Date | 05/03/2010
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Provider Practice Location Address
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Address Line | 4116 W CRAIG RD SUITE 100
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City | N LAS VEGAS
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State | NV
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Zip | 89032-2732
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Country | US
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Telephone | 702-655-1199
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Fax | 702-646-0630
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Provider Business Mailing Address
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Address Line | 4116 W CRAIG RD SUITE 100
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City | N LAS VEGAS
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State | NV
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Zip | 89032-2732
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Country | US
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Telephone | 702-655-1199
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Fax | 702-646-0630
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN KEITH FIFE
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Credential | D.C.
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Telephone | 702-655-1199
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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 | B00612
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License Number State | NV
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