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NPI Code Detail

MEDICARE: KEVIN THOMAS BAHOORA ADVANCED SPINE AND WELLNESS

MEDICARE: KEVIN THOMAS BAHOORA ADVANCED SPINE AND WELLNESS
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
1111N00000XChiropractorB-799NV

General Provider Information

NPI Number : 1447524855
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEVIN THOMAS BAHOORA ADVANCED SPINE AND WELLNESS
Provider Business Mailing Address
First Line : 7035 W. ANN RD #160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3868
Country : US
Telephone Number : 702-396-0277
Fax Number : 702-396-3790
Provider Business Practice Location Address
First Line : 7035 W. ANN RD #160
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3868
Country : US
Telephone Number : 702-396-0277
Fax Number : 702-396-3790
Authorized Official
Title or Position : CHIROPRACTIC PHYSICIAN/OWNER/PRES
Name : KEVEN THOMAS BAHOORA
Credential : D.C.
Telephone Number : 702-396-0277
Provider Enumeration Date : 03/02/2012
Last Update Date : 04/12/2022

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Directions to “KEVIN THOMAS BAHOORA ADVANCED SPINE AND WELLNESS ” Practice Location

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