Provider Demographics
NPI:1457757577
Name:INJURY CARE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:INJURY CARE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CHIROPRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALETA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-255-7800
Mailing Address - Street 1:6130 W. SAHARA AVE.
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3150
Mailing Address - Country:US
Mailing Address - Phone:702-255-7800
Mailing Address - Fax:702-778-1495
Practice Address - Street 1:6130 W. SAHARA AVE.
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3150
Practice Address - Country:US
Practice Address - Phone:702-255-7800
Practice Address - Fax:702-778-1495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-17
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01174111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV08803Medicare UPIN
NV102209Medicare PIN