Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | B00609 | NV |
Y | 225400000X | Rehabilitation Practitioner | B-609 | NV |
N | 225C00000X | Rehabilitation Counselor |
NPI | 1124397260 |
---|---|
Provider Name | Dr. Robert Chase |
First Address | Henderson, NV 89014-3773 |
Second Address | Henderson, NV 89014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2011 |
Last Update Date | 15/02/2013 |