MEDICARE: DARRIN DEVOREE BANG 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	B01619	NV
2	111N00000X	Chiropractor	11742	TX

General Provider Information

NPI Number	:	1205109733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARRIN DEVOREE BANG DC

Provider Business Mailing Address
First Line	:	7255 W SUNSET RD APT 2105
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1913
Country	:	US
Telephone Number	:	702-752-9258
Fax Number	:

Provider Business Practice Location Address
First Line	:	2415 LAS VEGAS BLVD N STE 105
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89030-5861
Country	:	US
Telephone Number	:	702-382-3400
Fax Number	:

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

Provider Enumeration Date	:	02/14/2012
Last Update Date	:	03/30/2018

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