Provider Demographics
NPI:1538578505
Name:JOSEPH R NICOLA DC PC
Entity type:Organization
Organization Name:JOSEPH R NICOLA DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:NICOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-252-7246
Mailing Address - Street 1:7380 W SAHARA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-2760
Mailing Address - Country:US
Mailing Address - Phone:702-252-7246
Mailing Address - Fax:702-251-9650
Practice Address - Street 1:7380 W SAHARA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2760
Practice Address - Country:US
Practice Address - Phone:702-252-7246
Practice Address - Fax:702-251-9650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty