MEDICARE: DILLAN VAN NESS

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	B02046	NV

General Provider Information

NPI Number	:	1174345433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DILLAN VAN NESS

Provider Business Mailing Address
First Line	:	8680 W WARM SPRINGS RD STE 155
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1828
Country	:	US
Telephone Number	:	702-702-5446
Fax Number	:

Provider Business Practice Location Address
First Line	:	670 S GREEN VALLEY PKWY STE 150
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-0435
Country	:	US
Telephone Number	:	702-293-9100
Fax Number	:

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

Provider Enumeration Date	:	10/28/2024
Last Update Date	:	10/28/2024

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Directions to “ DILLAN VAN NESS ” Practice Location

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