Provider Demographics
NPI:1114795481
Name:STIRRUP, SAMUEL JASON (DC)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:JASON
Last Name:STIRRUP
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 1:1489 W WARM SPRINGS RD STE 125
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-7637
Mailing Address - Country:US
Mailing Address - Phone:702-209-2525
Mailing Address - Fax:
Practice Address - Street 1:1489 W WARM SPRINGS RD STE 125
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-7637
Practice Address - Country:US
Practice Address - Phone:702-209-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01995111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor