Provider Demographics
NPI:1629160270
Name:HERRERA, ANTHONY CARL (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:CARL
Last Name:HERRERA
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 1:3596 BAKER LN
Mailing Address - Street 2:SUITE 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:SUITE 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
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV350046767OtherRAILROAD MEDICARE NUMBER
NVV100459Medicare PIN