Provider Demographics
NPI:1922080142
Name:WHALEY, VANCE F (DC)
Entity Type:Individual
Prefix:
First Name:VANCE
Middle Name:F
Last Name:WHALEY
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 1:9330 W FLAMINGO RD STE 112A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6447
Mailing Address - Country:US
Mailing Address - Phone:702-932-6100
Mailing Address - Fax:702-932-6102
Practice Address - Street 1:9330 W FLAMINGO RD STE 112A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6447
Practice Address - Country:US
Practice Address - Phone:702-932-6100
Practice Address - Fax:702-932-6102
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00956111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506102Medicaid
NVU93841Medicare UPIN
NVV37202Medicare PIN