Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | B-794 | NV |
NPI | 1427100692 |
---|---|
Provider Name | Dr. Daniel Joseph Ragusa |
First Address | Las Vegas, NV 89145-4739 |
Second Address | Las Vegas, NV 89108-4533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
061658090 | TAX IDENTIFIER (01) | NV |