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General NPI Number Information
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NPI Number | 1841323326
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Entity Type | Organization
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Legal Business Name | BURKE SPINAL CARE, LTD
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 7240 W LAKE MEAD BLVD SUITE 3
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City | LAS VEGAS
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State | NV
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Zip | 89128-8356
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Country | US
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Telephone | 702-453-0440
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Fax | 702-453-0550
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Provider Business Mailing Address
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Address Line | 7240 W LAKE MEAD BLVD SUITE 3
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City | LAS VEGAS
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State | NV
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Zip | 89128-8356
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Country | US
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Telephone | 702-453-0440
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Fax | 702-453-0550
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. CAMERON MITCHELL DUDLEY
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Credential | D.C.
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Telephone | 702-453-0440
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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 | B00447
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License Number State | NV
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