| |
16916 State Highway 14, Mojave, CA 93501-1226 | |
(661) 824-9732 | |
(661) 824-1638 |
Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor - Radiology |
Location | 16916 State Highway 14, Mojave, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336227388 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111NR0200X | Chiropractor - Radiology | DC16780 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
16916 State Highway 14, Mojave, CA 93501-1226 Ph: (661) 824-9732 | 16916 State Highway 14, Mojave, CA 93501-1226 Ph: (661) 824-9732 |
Gerald Leray Nissen, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 16916 State Highway 14, Mojave, CA 93501 Phone: 661-824-9732 Fax: 661-824-1638 |