Provider Demographics
NPI:1053926253
Name:KOEVEN CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:KOEVEN CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEVEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-525-1484
Mailing Address - Street 1:705 TODD CT
Mailing Address - Street 2:
Mailing Address - City:FERNLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89408-7558
Mailing Address - Country:US
Mailing Address - Phone:775-525-1484
Mailing Address - Fax:775-451-9504
Practice Address - Street 1:1724 C ST
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4874
Practice Address - Country:US
Practice Address - Phone:775-525-1484
Practice Address - Fax:775-451-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty