Provider Demographics
NPI:1912107855
Name:PETER B LITTLEHALE DC LTD
Entity Type:Organization
Organization Name:PETER B LITTLEHALE DC LTD
Other - Org Name:LITTLEHALE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:B
Authorized Official - Last Name:LITTLEHALE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-825-1515
Mailing Address - Street 1:530 E PLUMB LN #2
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-3550
Mailing Address - Country:US
Mailing Address - Phone:775-825-1515
Mailing Address - Fax:775-825-1512
Practice Address - Street 1:530 E PLUMB LN #2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3550
Practice Address - Country:US
Practice Address - Phone:775-825-1515
Practice Address - Fax:775-825-1512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00391111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101456Medicare PIN