Provider Demographics
NPI:1083801625
Name:ENLIGHTENED HEALING
Entity Type:Organization
Organization Name:ENLIGHTENED HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:NIGHTINGALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-826-8687
Mailing Address - Street 1:355 GENTRY WAY
Mailing Address - Street 2:SUITE C
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4608
Mailing Address - Country:US
Mailing Address - Phone:775-826-8687
Mailing Address - Fax:775-826-8692
Practice Address - Street 1:355 GENTRY WAY
Practice Address - Street 2:SUITE C
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-4608
Practice Address - Country:US
Practice Address - Phone:775-826-8687
Practice Address - Fax:775-826-8692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty