MEDICARE: COLARUSSO AND NOZAWA LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	B673	NV

General Provider Information

NPI Number	:	1023297058
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLARUSSO AND NOZAWA LTD

Provider Business Mailing Address
First Line	:	3417 WHITE BARK PINE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129-8119
Country	:	US
Telephone Number	:	702-254-2225
Fax Number	:

Provider Business Practice Location Address
First Line	:	6015 S FORT APACHE RD
Second Line	:	STE 180
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-5543
Country	:	US
Telephone Number	:	702-944-2225
Fax Number	:	702-926-5560

Authorized Official
Title or Position	:	SECRETARY
Name	:	KEVIN K NOZAWA
Credential	:	D.C.
Telephone Number	:	702-944-2225

Provider Enumeration Date	:	10/26/2007
Last Update Date	:	03/06/2013

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