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General NPI Number Information
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NPI Number | 1467791905
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Entity Type | Organization
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Legal Business Name | JERIAN CHIROPRACTIC LLC
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 09/21/2021
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Provider Practice Location Address
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Address Line | 690 N VALLE VERDE DR SUITE 4
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City | HENDERSON
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State | NV
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Zip | 89014-2397
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Country | US
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Telephone | 702-454-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 1999 W SUNSET RD STE 4
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City | HENDERSON
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State | NV
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Zip | 89014-2342
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Country | US
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Telephone | 702-454-9700
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ANTRANIG V. JERIAN
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Credential | D.C.
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Telephone | 702-454-9700
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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 | B01173
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License Number State | NV
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