Provider Demographics
NPI:1912139445
Name:MOEHRLE, JOHN ADAM (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ADAM
Last Name:MOEHRLE
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 1:62 REYBURN DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-2720
Mailing Address - Country:US
Mailing Address - Phone:702-806-5078
Mailing Address - Fax:702-896-0058
Practice Address - Street 1:7291 S EASTERN AVE STE B
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0437
Practice Address - Country:US
Practice Address - Phone:702-896-0080
Practice Address - Fax:702-896-0058
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB00159111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor