Provider Demographics
NPI:1235330291
Name:LEAVITT, DANIEL CRAIG (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CRAIG
Last Name:LEAVITT
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 1:4901 WEST DESERT INN ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-8101
Mailing Address - Country:US
Mailing Address - Phone:702-362-2225
Mailing Address - Fax:702-876-6044
Practice Address - Street 1:4901 W DESERT INN RD STE 2
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-8100
Practice Address - Country:US
Practice Address - Phone:702-362-2225
Practice Address - Fax:702-876-6044
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00236111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor