Provider Demographics
NPI:1750809869
Name:BUFFALO CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BUFFALO CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-898-8300
Mailing Address - Street 1:6420 SPRING MOUNTAIN RD.
Mailing Address - Street 2:SUITE 18
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-898-8300
Mailing Address - Fax:702-898-8301
Practice Address - Street 1:6420 SPRING MOUNTAIN RD.
Practice Address - Street 2:SUITE 18
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-898-8300
Practice Address - Fax:702-898-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV=========OtherTIN