Provider Demographics
NPI:1962629279
Name:PROCARE CHIROPRACTIC
Entity Type:Organization
Organization Name:PROCARE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FORBES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-877-0707
Mailing Address - Street 1:898 S VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-4412
Mailing Address - Country:US
Mailing Address - Phone:702-877-0707
Mailing Address - Fax:702-877-5611
Practice Address - Street 1:898 S VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-4412
Practice Address - Country:US
Practice Address - Phone:702-877-0707
Practice Address - Fax:702-877-5611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB340111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3602108Medicaid
NV3602108Medicaid
NVT67205Medicare UPIN