Provider Demographics
NPI:1922375294
Name:SIM, TEDDY B JR (DC)
Entity Type:Individual
Prefix:DR
First Name:TEDDY
Middle Name:B
Last Name:SIM
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:321 N PECOS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-1347
Mailing Address - Country:US
Mailing Address - Phone:702-263-4925
Mailing Address - Fax:702-263-6874
Practice Address - Street 1:321 N PECOS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-1347
Practice Address - Country:US
Practice Address - Phone:702-263-4925
Practice Address - Fax:702-263-6874
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVB01445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor