Provider Demographics
NPI:1649208232
Name:KERRI A GALVIN DC
Entity Type:Organization
Organization Name:KERRI A GALVIN DC
Other - Org Name:GALVIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GALVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-562-2202
Mailing Address - Street 1:7380 S EASTERN AVE
Mailing Address - Street 2:SUITE 125
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1550
Mailing Address - Country:US
Mailing Address - Phone:702-562-2202
Mailing Address - Fax:702-562-2206
Practice Address - Street 1:7380 S EASTERN AVE
Practice Address - Street 2:SUITE 125
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1550
Practice Address - Country:US
Practice Address - Phone:702-562-2202
Practice Address - Fax:702-562-2206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-00892111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV 102435Medicare PIN