Provider Demographics
NPI:1801160023
Name:PTCII INC
Entity type:Organization
Organization Name:PTCII INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:DUMLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-312-7920
Mailing Address - Street 1:9075 S EASTERN AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-4858
Mailing Address - Country:US
Mailing Address - Phone:702-312-7920
Mailing Address - Fax:702-312-9714
Practice Address - Street 1:9075 S EASTERN AVE STE 4
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-4858
Practice Address - Country:US
Practice Address - Phone:702-312-7920
Practice Address - Fax:702-312-9714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00678111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3602067Medicaid
NVU78914Medicare UPIN
NV3602067Medicaid