Provider Demographics
NPI:1023865037
Name:BATENCOURT, DAVID (DC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BATENCOURT
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 1:2729 BROOKSTONE CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2443
Mailing Address - Country:US
Mailing Address - Phone:772-212-5408
Mailing Address - Fax:
Practice Address - Street 1:2729 BROOKSTONE CT
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2443
Practice Address - Country:US
Practice Address - Phone:772-212-5408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor