MEDICARE: DR. CHRISTINA LOUISA WORLEY-TABOR OMD, CHT.

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	171100000X	Acupuncturist	2044	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NV20212006368	OTHER	NV	STATE ISSUED

General Provider Information

NPI Number	:	1770175259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA LOUISA WORLEY-TABOR OMD, CHT.

Provider Business Mailing Address
First Line	:	2657 WINDMILL PKWY # 658
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89074-3384
Country	:	US
Telephone Number	:	702-343-4905
Fax Number	:

Provider Business Practice Location Address
First Line	:	8610 S EASTERN AVE STE 3
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-2836
Country	:	US
Telephone Number	:	702-343-4905
Fax Number	:

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

Provider Enumeration Date	:	02/06/2021
Last Update Date	:	02/06/2021

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