Provider Demographics
NPI:1982635413
Name:MENARD, ROBERT P (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:MENARD
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 1:2637 W HORIZON RIDGE PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4834
Mailing Address - Country:US
Mailing Address - Phone:702-822-6325
Mailing Address - Fax:702-644-6325
Practice Address - Street 1:2637 W HORIZON RIDGE PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4834
Practice Address - Country:US
Practice Address - Phone:702-822-6325
Practice Address - Fax:702-644-6325
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV35972Medicare PIN
NVU91178Medicare UPIN