Provider Demographics
NPI:1386842532
Name:ROVETTI, PAUL DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DOUGLAS
Last Name:ROVETTI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:655 GREENBRAE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-3171
Mailing Address - Country:US
Mailing Address - Phone:775-355-1231
Mailing Address - Fax:775-358-6843
Practice Address - Street 1:655 GREENBRAE DR
Practice Address - Street 2:SUITE C
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-3171
Practice Address - Country:US
Practice Address - Phone:775-355-1231
Practice Address - Fax:775-358-6843
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV880222338Medicare PIN