Provider Demographics
NPI:1831307347
Name:NICOLA, JOSEPH ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ROBERT
Last Name:NICOLA
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 1:7380 W SAHARA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2760
Mailing Address - Country:US
Mailing Address - Phone:702-252-7246
Mailing Address - Fax:702-251-9650
Practice Address - Street 1:7380 W SAHARA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2760
Practice Address - Country:US
Practice Address - Phone:702-252-7246
Practice Address - Fax:702-251-9650
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-916111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEU91056Medicare UPIN