Individual
DR. DALE ALLEN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2389 RENAISSANCE DR, STE A, LAS VEGAS, NV 89119-6106
(702) 458-1495
(702) 458-7869
Mailing address
2389 RENAISSANCE DR, STE A, LAS VEGAS, NV 89119-6106
(702) 458-1495
(702) 458-7869
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
B119
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VWJBJPO1
MEDICARE PTAN
NV
Enumeration date
12/06/2005
Last updated
01/21/2009
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