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894 Southwood Blvd, Incline Vlg, NV 89451-9435 | |
(775) 831-5544 | |
(775) 831-5545 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 894 Southwood Blvd, Incline Vlg, Nevada |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851925226 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Amy Vevoda |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1740209931 PECOS PAC ID: 0547268989 Enrollment ID: I20190524000452 |
Provider Name | Jonathan Malley |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1902429384 PECOS PAC ID: 6002235579 Enrollment ID: I20201001003045 |
Provider Name | Emma Genevieve Freeze |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1871287631 PECOS PAC ID: 4385008929 Enrollment ID: I20230914002168 |
Mailing Address | Practice Location Address |
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894 Southwood Blvd, Incline Vlg, NV 89451-9435 Ph: (775) 831-5544 | 894 Southwood Blvd, Incline Vlg, NV 89451-9435 Ph: (775) 831-5544 |