MEDICARE: DR. RONALD LEE GREENAWALT D.C., D.A.B.C.O.

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	111NX0800X	Orthopedic Chiropractor	B00362	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891779302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD LEE GREENAWALT D.C., D.A.B.C.O.

Provider Business Mailing Address
First Line	:	7500 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2742
Country	:	US
Telephone Number	:	702-363-8989
Fax Number	:	702-363-3573

Provider Business Practice Location Address
First Line	:	7500 W SAHARA AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-2742
Country	:	US
Telephone Number	:	702-363-8989
Fax Number	:	702-363-3573

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	07/15/2023

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