Provider Demographics
NPI:1043388275
Name:LIN, MICHAEL (DC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5288 SPRING MOUNTAIN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8714
Mailing Address - Country:US
Mailing Address - Phone:702-251-9911
Mailing Address - Fax:702-248-3886
Practice Address - Street 1:5288 SPRING MOUNTAIN RD STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8714
Practice Address - Country:US
Practice Address - Phone:702-251-9911
Practice Address - Fax:702-248-3886
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB744111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
36826Medicare ID - Type Unspecified
NVU74584Medicare UPIN