MEDICARE: QUAN CHIROPRACTIC LLC

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

General Provider Information

NPI Number	:	1558618009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUAN CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	4282 HALLENDALE DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-4933
Country	:	US
Telephone Number	:	702-858-8824
Fax Number	:	702-222-3444

Provider Business Practice Location Address
First Line	:	3047 S DECATUR BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-7144
Country	:	US
Telephone Number	:	702-858-8824
Fax Number	:	702-222-3444

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JULIE QUAN
Credential	:	D.C.
Telephone Number	:	702-858-8824

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	08/14/2012

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