Provider Demographics
NPI:1760632178
Name:ADVANCED CHIROPRACTIC
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-727-1188
Mailing Address - Street 1:3551 PAHRUMP VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-8101
Mailing Address - Country:US
Mailing Address - Phone:775-727-1188
Mailing Address - Fax:775-727-1195
Practice Address - Street 1:1470 E CALVADA BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-3905
Practice Address - Country:US
Practice Address - Phone:775-727-1188
Practice Address - Fax:775-717-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty