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General NPI Number Information
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NPI Number | 1659362747
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Entity Type | Individual
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Provider Name | STEPHEN FAIR DC
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Gender | Male
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Dates
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Enumeration Date | 10/29/2005
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Last Update Date | 11/19/2014
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Provider Practice Location Address
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Address Line | 825 S 7TH STREET
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City | LAS VEGAS
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State | NV
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Zip | 89101
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Country | US
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Telephone | 702-256-8080
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Fax | 702-256-8081
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Provider Business Mailing Address
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Address Line | 10120 W FLAMINGO RD #4-265
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City | LAS VEGAS
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State | NV
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Zip | 89147
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Country | US
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Telephone | 702-256-8080
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Fax | 702-256-8081
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | B00922
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License Number State | NV
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