Provider Demographics
NPI:1902076425
Name:5 STAR MOBILE CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:5 STAR MOBILE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:HANDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-506-6922
Mailing Address - Street 1:2440 MILLCROFT DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-4956
Mailing Address - Country:US
Mailing Address - Phone:702-506-6922
Mailing Address - Fax:702-456-5061
Practice Address - Street 1:2440 MILLCROFT DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-4956
Practice Address - Country:US
Practice Address - Phone:702-506-6922
Practice Address - Fax:702-456-5061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-00861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty