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NPI Code Detail

MEDICARE: THE SPINE, DISC & NERVE DOCTOR, INC.

MEDICARE: THE SPINE, DISC & NERVE DOCTOR, INC.
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
1111NR0400XRehabilitation ChiropractorB01660NV

General Provider Information

NPI Number : 1194226829
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE SPINE, DISC & NERVE DOCTOR, INC.
Provider Business Mailing Address
First Line : PO BOX 336543
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89033-6543
Country : US
Telephone Number : 702-448-4566
Fax Number :
Provider Business Practice Location Address
First Line : 3940 N MLK BLVD STE 107
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-6607
Country : US
Telephone Number : 702-448-4566
Fax Number : 725-605-3464
Authorized Official
Title or Position : PRESIDENT, OWNER & OPERATOR
Name : DR. PATRICK R.E. DAVIS
Credential : DC
Telephone Number : 702-448-4566
Provider Enumeration Date : 02/27/2018
Last Update Date : 02/27/2018

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Directions to “THE SPINE, DISC & NERVE DOCTOR, INC. ” Practice Location

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