Provider Demographics
NPI:1437476280
Name:DR. BRIAN K. FIFE, INC
Entity Type:Organization
Organization Name:DR. BRIAN K. FIFE, INC
Other - Org Name:ADVANCED CHIROPRACTIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:FIFE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-655-1199
Mailing Address - Street 1:4116 W CRAIG RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:N LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-2732
Mailing Address - Country:US
Mailing Address - Phone:702-655-1199
Mailing Address - Fax:702-646-0630
Practice Address - Street 1:4116 W CRAIG RD
Practice Address - Street 2:SUITE 100
Practice Address - City:N LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-2732
Practice Address - Country:US
Practice Address - Phone:702-655-1199
Practice Address - Fax:702-646-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU69503Medicare UPIN
NVV34029Medicare PIN