Provider Demographics
NPI:1619709904
Name:VELAZQUEZ CHIROPRACTIC LLC
Entity type:Organization
Organization Name:VELAZQUEZ CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:725-253-5203
Mailing Address - Street 1:2000 S EASTERN AVE STE D
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-4100
Mailing Address - Country:US
Mailing Address - Phone:725-206-5562
Mailing Address - Fax:725-206-5392
Practice Address - Street 1:2000 S EASTERN AVE STE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-4100
Practice Address - Country:US
Practice Address - Phone:725-206-5562
Practice Address - Fax:725-206-5392
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VELAZQUEZ CHIROPRACTIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-15
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty