Provider Demographics
NPI:1255457396
Name:SALEM, JANE MARY (DC)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:MARY
Last Name:SALEM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8475 S EASTERN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2862
Mailing Address - Country:US
Mailing Address - Phone:702-898-3311
Mailing Address - Fax:702-898-3383
Practice Address - Street 1:8475 S EASTERN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2862
Practice Address - Country:US
Practice Address - Phone:702-898-3311
Practice Address - Fax:702-898-3383
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-715111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVU74504Medicare UPIN