MEDICARE: GREGORY U MACKAY PLLC

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	B745	NV

General Provider Information

NPI Number	:	1699951855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY U MACKAY PLLC

Provider Business Mailing Address
First Line	:	7450 W CHEYENNE AVE #114
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129
Country	:	US
Telephone Number	:	702-655-2999
Fax Number	:	702-315-3773

Provider Business Practice Location Address
First Line	:	7450 W CHEYENNE AVE #114
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89129
Country	:	US
Telephone Number	:	702-655-2999
Fax Number	:	702-315-3773

Authorized Official
Title or Position	:	OFFICE/BILLING MANAGER
Name	:	CRYSTAL PETE
Credential	:
Telephone Number	:	702-480-6887

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	03/25/2022

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