MEDICARE: DR. PASQUALE J LAURITO 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	B617	NV

General Provider Information

NPI Number	:	1467609958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PASQUALE J LAURITO DC

Provider Business Mailing Address
First Line	:	2401 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2123
Country	:	US
Telephone Number	:	702-312-0561
Fax Number	:	702-312-0614

Provider Business Practice Location Address
First Line	:	2401 W CHARLESTON BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2123
Country	:	US
Telephone Number	:	702-312-0561
Fax Number	:	702-312-0614

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

Provider Enumeration Date	:	08/26/2008
Last Update Date	:	08/26/2008

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Directions to “ DR. PASQUALE J LAURITO DC” Practice Location

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