Provider Demographics
NPI:1558553925
Name:OASIS CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:OASIS CHIROPRACTIC CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROESSNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-346-5030
Mailing Address - Street 1:840 PINNACLE CT STE 5A
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-3322
Mailing Address - Country:US
Mailing Address - Phone:702-346-5030
Mailing Address - Fax:702-345-3256
Practice Address - Street 1:840 PINNACLE CT
Practice Address - Street 2:STE 5A
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-3303
Practice Address - Country:US
Practice Address - Phone:702-346-5030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01006111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV38462Medicare PIN