Provider Demographics
NPI:1093704421
Name:HALLGREN, RICK W (DC)
Entity Type:Individual
Prefix:DR
First Name:RICK
Middle Name:W
Last Name:HALLGREN
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 1:4925 W CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-2730
Mailing Address - Country:US
Mailing Address - Phone:702-656-7460
Mailing Address - Fax:702-656-7461
Practice Address - Street 1:4925 W CRAIG RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-2730
Practice Address - Country:US
Practice Address - Phone:702-656-7460
Practice Address - Fax:702-656-7461
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor