MEDICARE: DR. MICHAEL ROGALL EPPERSON 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	B01614	NV

General Provider Information

NPI Number	:	1477080265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ROGALL EPPERSON DC

Provider Business Mailing Address
First Line	:	8678 SPRING MOUNTAIN RD STE 103
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4103
Country	:	US
Telephone Number	:	702-384-0000
Fax Number	:	702-221-4853

Provider Business Practice Location Address
First Line	:	8678 SPRING MOUNTAIN RD STE 103
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-4103
Country	:	US
Telephone Number	:	702-384-0000
Fax Number	:	702-221-4853

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

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	11/28/2018

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