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General NPI Number Information
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NPI Number | 1700972767
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Entity Type | Organization
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Legal Business Name | CAUGHLIN RANCH CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 4792 CAUGHLIN PKWY STE 207
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City | RENO
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State | NV
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Zip | 89509-0911
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Country | US
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Telephone | 775-828-9665
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Fax | 775-828-7605
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Provider Business Mailing Address
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Address Line | 4792 CAUGHLIN PKWY STE 207
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City | RENO
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State | NV
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Zip | 89509-0911
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Country | US
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Telephone | 775-828-9665
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Fax | 775-828-7605
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Authorized Official
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Title or Position | OWNER
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Name | XAVIER MARTINEZ
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Credential | D.C.
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Telephone | 775-828-9665
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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 | B-557
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License Number State | NV
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