Provider Demographics
NPI:1346663598
Name:GOZDZIKOWSKI, PETER ANDREW (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:ANDREW
Last Name:GOZDZIKOWSKI
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 1:3412 CATHERINE MERMET AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-6484
Mailing Address - Country:US
Mailing Address - Phone:386-523-4751
Mailing Address - Fax:
Practice Address - Street 1:3820 W ANN RD STE 130
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-4401
Practice Address - Country:US
Practice Address - Phone:702-233-2626
Practice Address - Fax:702-361-2626
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor