MEDICARE: DANIEL NICOLAUS 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	B02013	NV

General Provider Information

NPI Number	:	1144955071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL NICOLAUS DC

Provider Business Mailing Address
First Line	:	7317 DAZZLE POINT ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-4746
Country	:	US
Telephone Number	:	724-986-3935
Fax Number	:

Provider Business Practice Location Address
First Line	:	7317 DAZZLE POINT ST
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89084-4746
Country	:	US
Telephone Number	:	724-986-3935
Fax Number	:

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

Provider Enumeration Date	:	07/25/2022
Last Update Date	:	06/08/2024

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Directions to “ DANIEL NICOLAUS DC” Practice Location

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