Provider Demographics
NPI:1588845549
Name:RENO CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:RENO CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-827-1833
Mailing Address - Street 1:3596 BAKER LN
Mailing Address - Street 2:STE. B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-5410
Mailing Address - Country:US
Mailing Address - Phone:775-827-1833
Mailing Address - Fax:775-827-1024
Practice Address - Street 1:3596 BAKER LN
Practice Address - Street 2:STE. B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5410
Practice Address - Country:US
Practice Address - Phone:775-827-1833
Practice Address - Fax:775-827-1024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV100458Medicare PIN