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General NPI Number Information
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NPI Number | 1841018942
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Entity Type | Individual
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Provider Name | JACOB COVERT
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Gender | Male
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 11/03/2024
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Provider Practice Location Address
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Address Line | 9400 DOUBLE DIAMOND PKWY
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City | RENO
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State | NV
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Zip | 89521-5922
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Country | US
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Telephone | 775-848-0540
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Fax |
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Provider Business Mailing Address
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Address Line | 13593 GOLD RUN DR
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City | RENO
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State | NV
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Zip | 89521-8308
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Country | US
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Telephone |
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Fax |
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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 | B02068
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License Number State | NV
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