MEDICARE: DR. KEVIN P. COLAN 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	B295	NV

General Provider Information

NPI Number	:	1487797478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN P. COLAN D.C.

Provider Business Mailing Address
First Line	:	1301 CRYSTAL MOUNTAIN DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1472
Country	:	US
Telephone Number	:	702-254-2394
Fax Number	:	702-562-2499

Provider Business Practice Location Address
First Line	:	7488 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2740
Country	:	US
Telephone Number	:	702-562-0652
Fax Number	:	702-562-2499

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

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	07/08/2007

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