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NPI Code Detail

MEDICARE: DR. ALBERT DELOY BLANCHARD JR. D.C.

MEDICARE:  DR. ALBERT DELOY BLANCHARD JR. D.C.
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
1111N00000XChiropractorB01319NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BZ300ZOTHERNVMEDICARE PTAN

General Provider Information

NPI Number : 1942441845
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALBERT DELOY BLANCHARD JR. D.C.
Provider Business Mailing Address
First Line : 2851 N TENAYA WAY
Second Line : #103
City : LAS VEGAS
State : NV
Zip : 89128-0435
Country : US
Telephone Number : 702-309-4878
Fax Number : 702-309-4878
Provider Business Practice Location Address
First Line : 2870 S MARYLAND PKWY
Second Line : #100
City : LAS VEGAS
State : NV
Zip : 89109-5031
Country : US
Telephone Number : 702-309-4878
Fax Number : 702-577-3334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2009
Last Update Date : 03/04/2015

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Directions to “ DR. ALBERT DELOY BLANCHARD JR. D.C.” Practice Location

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