Provider Demographics
NPI:1588249841
Name:WEICH, RAYMOND DANIEL (DC)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:DANIEL
Last Name:WEICH
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 1:8465 W SAHARA AVE # 111-249
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8960
Mailing Address - Country:US
Mailing Address - Phone:702-509-5098
Mailing Address - Fax:702-924-6356
Practice Address - Street 1:600 S RANCHO DR STE 113-B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4867
Practice Address - Country:US
Practice Address - Phone:702-509-5098
Practice Address - Fax:702-924-6356
Is Sole Proprietor?:No
Enumeration Date:2021-03-17
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01863111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor