MEDICARE: DR. NATHAN DAVID NOAKES DC

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	B02010	NV

General Provider Information

NPI Number	:	1083614945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATHAN DAVID NOAKES DC

Provider Business Mailing Address
First Line	:	1591 N BUFFALO DR
Second Line	:	SUITE #120
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3632
Country	:	US
Telephone Number	:	702-838-8988
Fax Number	:	702-838-3903

Provider Business Practice Location Address
First Line	:	1591 N BUFFALO DR
Second Line	:	SUITE #120
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-3632
Country	:	US
Telephone Number	:	702-838-8988
Fax Number	:	702-838-3903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/08/2007

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