Provider Demographics
NPI:1013013655
Name:COLUCCI, MARGARET R (DC)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:R
Last Name:COLUCCI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2085 VILLAGE CENTER CIR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6262
Mailing Address - Country:US
Mailing Address - Phone:702-880-5335
Mailing Address - Fax:702-880-5336
Practice Address - Street 1:2085 VILLAGE CENTER CIR
Practice Address - Street 2:SUITE 110
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6262
Practice Address - Country:US
Practice Address - Phone:702-880-5335
Practice Address - Fax:702-880-5336
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU10291Medicare UPIN