Provider Demographics
NPI:1053583369
Name:FERNLEY CHIROPRACTIC, INC
Entity type:Organization
Organization Name:FERNLEY CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-575-5511
Mailing Address - Street 1:240 US HIGHWAY 95A S
Mailing Address - Street 2:SUITE B
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-9705
Mailing Address - Country:US
Mailing Address - Phone:775-575-5511
Mailing Address - Fax:
Practice Address - Street 1:240 US HIGHWAY 95A S
Practice Address - Street 2:SUITE B
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9705
Practice Address - Country:US
Practice Address - Phone:775-575-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty