Provider Demographics
NPI:1477205144
Name:LOVELAND, CORBIN THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:CORBIN
Middle Name:THOMAS
Last Name:LOVELAND
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 1:11939 GILES ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-5500
Mailing Address - Country:US
Mailing Address - Phone:702-337-1119
Mailing Address - Fax:
Practice Address - Street 1:2625 W HORIZON RIDGE PKWY STE 140
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2896
Practice Address - Country:US
Practice Address - Phone:702-492-6325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01916111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor