Provider Demographics
NPI:1356481576
Name:KOURY-HAJAL, SHADIA (DC)
Entity type:Individual
Prefix:DR
First Name:SHADIA
Middle Name:
Last Name:KOURY-HAJAL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8512 COPPER MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7614
Mailing Address - Country:US
Mailing Address - Phone:702-435-1648
Mailing Address - Fax:702-259-0148
Practice Address - Street 1:2300 N RAINBOW BLVD
Practice Address - Street 2:#121 & 122
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-7350
Practice Address - Country:US
Practice Address - Phone:702-259-0233
Practice Address - Fax:702-259-0148
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor