Provider Demographics
NPI:1730479155
Name:STEPHEN J CHIARELLO LTD
Entity type:Organization
Organization Name:STEPHEN J CHIARELLO LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHIARELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-362-6303
Mailing Address - Street 1:2815 S JONES BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5307
Mailing Address - Country:US
Mailing Address - Phone:702-362-6303
Mailing Address - Fax:702-362-6607
Practice Address - Street 1:2815 S JONES BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5307
Practice Address - Country:US
Practice Address - Phone:702-362-6303
Practice Address - Fax:702-362-6607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1000050-205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty