Provider Demographics
NPI:1891888376
Name:ARMENTA, ROSA H JR (DC)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:H
Last Name:ARMENTA
Suffix:JR
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4840 E. BONANZA RD. #8
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110
Mailing Address - Country:US
Mailing Address - Phone:702-459-8900
Mailing Address - Fax:702-459-8989
Practice Address - Street 1:4840 E. BONANZA RD. #8
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110
Practice Address - Country:US
Practice Address - Phone:702-459-8900
Practice Address - Fax:702-459-8989
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC029270Medicare UPIN
CA21535Medicare UPIN
CADC29275Medicare ID - Type Unspecified