Provider Demographics
NPI:1295734879
Name:GAMETT, BRIAN CHRISTOPHER (DC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:GAMETT
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 1:2610 W HORIZON RIDGE PKWY
Mailing Address - Street 2:STE 104
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-2869
Mailing Address - Country:US
Mailing Address - Phone:702-492-6325
Mailing Address - Fax:702-492-0615
Practice Address - Street 1:2610 W HORIZON RIDGE PKWY
Practice Address - Street 2:STE 104
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2869
Practice Address - Country:US
Practice Address - Phone:702-492-6325
Practice Address - Fax:702-492-0615
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-924111N00000X
NVB924111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U92040Medicare UPIN
NV36816Medicare ID - Type Unspecified