Provider Demographics
NPI:1255451340
Name:COMPLETE NECK & BACK CARE OF SUMMERLIN INC
Entity type:Organization
Organization Name:COMPLETE NECK & BACK CARE OF SUMMERLIN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-363-3111
Mailing Address - Street 1:1930 VILLAGE CENTER CIR STE 11
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6238
Mailing Address - Country:US
Mailing Address - Phone:702-363-3111
Mailing Address - Fax:702-562-2822
Practice Address - Street 1:1930 VILLAGE CENTER CIR STE 11
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6238
Practice Address - Country:US
Practice Address - Phone:702-363-3111
Practice Address - Fax:702-562-2822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU76427Medicare UPIN
NVV104060Medicare PIN