Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | B01772 | NV |
NPI | 1063189413 |
---|---|
Provider Name | Dr. Jacob Almanrode |
First Address | Las Vegas, NV 89128-7334 |
Second Address | Las Vegas, NV 89128-6892 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2021 |
Last Update Date | 24/08/2021 |