MEDICARE: DR. JOHN H VIGIL D.C.

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	B01348	NV

General Provider Information

NPI Number	:	1174751713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN H VIGIL D.C.

Provider Business Mailing Address
First Line	:	7465 W LAKE MEAD BLVD
Second Line	:	STE. 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1032
Country	:	US
Telephone Number	:	702-562-1244
Fax Number	:	702-562-1245

Provider Business Practice Location Address
First Line	:	7465 W LAKE MEAD BLVD
Second Line	:	STE. 115
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1032
Country	:	US
Telephone Number	:	702-562-1244
Fax Number	:	702-562-1245

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

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	07/21/2010

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