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GERALD LERAY NISSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
16916 STATE HIGHWAY 14, MOJAVE, CA 93501-1226
(661) 824-9732
(661) 824-1638
Mailing address
16916 STATE HIGHWAY 14, MOJAVE, CA 93501-1226
(661) 824-9732
(661) 824-1638

Taxonomy

Speciality
Code
Description
License number
State
111NR0200X
Radiology Chiropractor
DC16780
CA
2471C3402X
Radiography Radiologic Technologist
Primary
RHC126137
CA

Other

Enumeration date
07/05/2006
Last updated
09/11/2025
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