Provider Demographics
NPI:1316257330
Name:BRIGGS CHIROPRACTIC PC
Entity type:Organization
Organization Name:BRIGGS CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-385-3090
Mailing Address - Street 1:1736 E CHARLESTON BLVD
Mailing Address - Street 2:#337
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-7900
Mailing Address - Country:US
Mailing Address - Phone:702-385-3090
Mailing Address - Fax:702-896-1217
Practice Address - Street 1:9555 S EASTERN AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-7992
Practice Address - Country:US
Practice Address - Phone:702-385-3090
Practice Address - Fax:702-896-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1093986465Medicare PIN