MEDICARE: CENTERED CARE 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	:	1588259063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERED CARE CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	1601 E BASIN AVE STE 304
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89060-4612
Country	:	US
Telephone Number	:	702-910-9348
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 E BASIN AVE STE 304
Second Line	:
City	:	PAHRUMP
State	:	NV
Zip	:	89060-4612
Country	:	US
Telephone Number	:	775-751-3316
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KATARINA SEPULVEDA
Credential	:	DC
Telephone Number	:	775-751-3316

Provider Enumeration Date	:	03/05/2021
Last Update Date	:	10/21/2021

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