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General NPI Number Information
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NPI Number | 1760632178
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Entity Type | Organization
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Legal Business Name | ADVANCED CHIROPRACTIC
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 02/09/2010
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Provider Practice Location Address
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Address Line | 1470 E CALVADA BLVD SUITE 300
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City | PAHRUMP
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State | NV
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Zip | 89048-3905
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Country | US
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Telephone | 775-727-1188
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Fax | 775-717-1195
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Provider Business Mailing Address
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Address Line | 3551 PAHRUMP VALLEY BLVD
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City | PAHRUMP
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State | NV
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Zip | 89048-8101
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Country | US
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Telephone | 775-727-1188
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Fax | 775-727-1195
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Authorized Official
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Title or Position | PRESIDENT
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Name | PILAR FERNANDEZ
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Credential | D.C.
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Telephone | 775-727-1188
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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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