Provider Demographics
NPI:1649528266
Name:DR. DEVIN J LUZOD INC
Entity type:Organization
Organization Name:DR. DEVIN J LUZOD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LUZOD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-566-4673
Mailing Address - Street 1:1930 VILLAGE CENTER CIR STE 11
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89134-6238
Mailing Address - Country:US
Mailing Address - Phone:702-944-4673
Mailing Address - Fax:
Practice Address - Street 1:1930 VILLAGE CENTER CIR STE 11
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-6238
Practice Address - Country:US
Practice Address - Phone:702-944-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. DEVIN J LUZOD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-29
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6133627-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV36528Medicare UPIN