Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | B-514 | NV |
NPI | 1013013655 |
---|---|
Provider Name | Margaret R. Colucci |
First Address | Las Vegas, NV 89134-6262 |
Second Address | Las Vegas, NV 89134-6262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 01/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U10291 | (02) | NV |