Provider Demographics
NPI:1063189413
Name:ALMANRODE, JACOB (DC)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:ALMANRODE
Suffix:
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 1:7940 VERDE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-7334
Mailing Address - Country:US
Mailing Address - Phone:669-224-2853
Mailing Address - Fax:
Practice Address - Street 1:2620 REGATTA DR STE 102
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-6892
Practice Address - Country:US
Practice Address - Phone:702-582-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-24
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01772111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician