Provider Demographics
NPI:1063077733
Name:PURVIS, JAMES STANLEY III (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:STANLEY
Last Name:PURVIS
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6592 N DECATUR BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1038
Mailing Address - Country:US
Mailing Address - Phone:702-396-4993
Mailing Address - Fax:
Practice Address - Street 1:6592 N DECATUR BLVD STE 115
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-1038
Practice Address - Country:US
Practice Address - Phone:702-396-4993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01751111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor