MEDICARE: DR. PAMELA HAMBLEN FLEMING 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	B361	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	B361	OTHER	NV	NEVADA STATE LICENSE

General Provider Information

NPI Number	:	1356475396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAMELA HAMBLEN FLEMING D.C.

Provider Business Mailing Address
First Line	:	6859 S EASTERN AVE
Second Line	:	SUITE 102
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0002
Country	:	US
Telephone Number	:	702-641-3008
Fax Number	:	702-471-7580

Provider Business Practice Location Address
First Line	:	6859 S EASTERN AVE
Second Line	:	SUITE 102
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-0002
Country	:	US
Telephone Number	:	702-641-3008
Fax Number	:	702-471-7580

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

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	05/24/2012

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