MEDICARE: JAMES M EARLE

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	1005684324	NV

General Provider Information

NPI Number	:	1962535039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES M EARLE

Provider Business Mailing Address
First Line	:	2595 S CIMARRON RD
Second Line	:	STE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7613
Country	:	US
Telephone Number	:	702-228-7147
Fax Number	:	702-228-7672

Provider Business Practice Location Address
First Line	:	2595 S CIMARRON RD
Second Line	:	STE 105
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-7613
Country	:	US
Telephone Number	:	702-228-7147
Fax Number	:	702-228-7672

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES MICHAEL EARLE
Credential	:	DC
Telephone Number	:	702-228-7147

Provider Enumeration Date	:	03/14/2007
Last Update Date	:	08/22/2020

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