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Individual

LON S TITEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
4660 S EASTERN AVE, SUITE 202, LAS VEGAS, NV 89119-6137
(702) 598-0500
(702) 433-0029
Mailing address
2956 FOXTAIL CREEK AVE, HENDERSON, NV 89052-7077
(702) 598-0500
(702) 433-0029

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
16902
CA
111N00000X
Chiropractor
Primary
B01059
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16902
CALIFORNIA LICENSE NUMBER
CA
01
B01059
NEVADA LICENSE NUMBER
NV
Enumeration date
08/08/2006
Last updated
07/08/2007
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