MEDICARE: MARIA C VELAZQUEZ

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	B01757	NV

General Provider Information

NPI Number	:	1609439447
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA C VELAZQUEZ

Provider Business Mailing Address
First Line	:	PO BOX 60071
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89160-0071
Country	:	US
Telephone Number	:	725-206-5562
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 S EASTERN AVE STE D
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89104-4100
Country	:	US
Telephone Number	:	725-206-5562
Fax Number	:	725-206-5392

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

Provider Enumeration Date	:	04/17/2019
Last Update Date	:	11/25/2024

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Directions to “ MARIA C VELAZQUEZ ” Practice Location

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