Provider Demographics
NPI:1942441845
Name:BLANCHARD, ALBERT DELOY JR (DC)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:DELOY
Last Name:BLANCHARD
Suffix:JR
Gender:M
Credentials:DC
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Mailing Address - Street 1:2851 N TENAYA WAY
Mailing Address - Street 2:#103
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0435
Mailing Address - Country:US
Mailing Address - Phone:702-309-4878
Mailing Address - Fax:702-309-4878
Practice Address - Street 1:2870 S MARYLAND PKWY
Practice Address - Street 2:#100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-5031
Practice Address - Country:US
Practice Address - Phone:702-309-4878
Practice Address - Fax:702-577-3334
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2015-03-04
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Provider Licenses
StateLicense IDTaxonomies
NVB01319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVBZ300ZOtherMEDICARE PTAN