Provider Demographics
NPI:1972594687
Name:ROOKHUYZEN, MARK STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:STEVEN
Last Name:ROOKHUYZEN
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 1:7291 S EASTERN AVE
Mailing Address - Street 2:STE B
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0436
Mailing Address - Country:US
Mailing Address - Phone:702-896-3416
Mailing Address - Fax:702-896-0058
Practice Address - Street 1:7291 S EASTERN AVE
Practice Address - Street 2:STE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0436
Practice Address - Country:US
Practice Address - Phone:702-896-3416
Practice Address - Fax:702-896-0058
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB000398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U16553Medicare UPIN