Provider Demographics
NPI:1932104684
Name:ROVETTI, DAVID G (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:ROVETTI
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 1:5365 MAE ANNE AVE
Mailing Address - Street 2:STE. B-2
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1840
Mailing Address - Country:US
Mailing Address - Phone:775-324-3700
Mailing Address - Fax:775-324-2370
Practice Address - Street 1:5365 MAE ANNE AVE
Practice Address - Street 2:STE. B-2
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89523-1840
Practice Address - Country:US
Practice Address - Phone:775-324-3700
Practice Address - Fax:775-324-2370
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-19
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-00317111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV102265Medicare PIN