Provider Demographics
NPI:1043543549
Name:BARBARA VAN HISE, DC, LLC
Entity Type:Organization
Organization Name:BARBARA VAN HISE, DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:VANHISE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-882-3555
Mailing Address - Street 1:604 E MUSSER ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-4200
Mailing Address - Country:US
Mailing Address - Phone:775-884-3555
Mailing Address - Fax:775-882-3588
Practice Address - Street 1:604 E MUSSER ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-4200
Practice Address - Country:US
Practice Address - Phone:775-884-3555
Practice Address - Fax:775-882-3588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-15
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVBO1250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBR110AMedicare UPIN