Provider Demographics
NPI:1164173191
Name:CHIDZIVA, MARLVIN SHOW (DC)
Entity Type:Individual
Prefix:
First Name:MARLVIN
Middle Name:SHOW
Last Name:CHIDZIVA
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 1:8960 W TROPICANA AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-8139
Mailing Address - Country:US
Mailing Address - Phone:702-979-6264
Mailing Address - Fax:
Practice Address - Street 1:8960 W TROPICANA AVE STE 500
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-8139
Practice Address - Country:US
Practice Address - Phone:702-979-6264
Practice Address - Fax:702-979-6264
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01829111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor