Provider Demographics
NPI:1639249071
Name:PECK, STEVEN D (D,C)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
Last Name:PECK
Suffix:
Gender:M
Credentials:D,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 S EASTERN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6192
Mailing Address - Country:US
Mailing Address - Phone:702-454-4336
Mailing Address - Fax:702-454-4268
Practice Address - Street 1:4680 S EASTERN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6192
Practice Address - Country:US
Practice Address - Phone:702-454-4336
Practice Address - Fax:702-454-4268
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV16357Medicare UPIN
NVV348Medicare PIN