Provider Demographics
NPI:1205109733
Name:BANG, DARRIN DEVOREE (DC)
Entity type:Individual
Prefix:
First Name:DARRIN
Middle Name:DEVOREE
Last Name:BANG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7255 W SUNSET RD APT 2105
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1913
Mailing Address - Country:US
Mailing Address - Phone:702-752-9258
Mailing Address - Fax:
Practice Address - Street 1:2415 LAS VEGAS BLVD N STE 105
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-5861
Practice Address - Country:US
Practice Address - Phone:702-382-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01619111N00000X
TX11742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor