Provider Demographics
NPI:1689846792
Name:ERIKSEN, TREVOR OVIE (BA, DC)
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:OVIE
Last Name:ERIKSEN
Suffix:
Gender:M
Credentials:BA, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 W 7TH ST
Mailing Address - Street 2:STE 23
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-2705
Mailing Address - Country:US
Mailing Address - Phone:775-329-3600
Mailing Address - Fax:
Practice Address - Street 1:855 W 7TH ST
Practice Address - Street 2:STE 23
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-2705
Practice Address - Country:US
Practice Address - Phone:775-329-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-28
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01046111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101156Medicare PIN