Provider Demographics
NPI:1821037847
Name:JANDA, ALEXANDER S (DC)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:S
Last Name:JANDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 MALL RING CIR
Mailing Address - Street 2:#205
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6665
Mailing Address - Country:US
Mailing Address - Phone:702-339-1142
Mailing Address - Fax:702-897-2896
Practice Address - Street 1:715 MALL RING CIR
Practice Address - Street 2:#205
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6665
Practice Address - Country:US
Practice Address - Phone:702-990-2225
Practice Address - Fax:702-990-7711
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U71023Medicare UPIN
NV102293Medicare ID - Type Unspecified