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Individual

DR. DOUGLAS B HERMANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
3551 E BONANZA RD, #108, LAS VEGAS, NV 89110-2198
(702) 437-0800
(702) 437-7857
Mailing address
3551 E BONANZA RD, #108, LAS VEGAS, NV 89110-2198
(702) 437-0800
(702) 437-7857

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
B498
NV
111N00000X
Chiropractor
B498 295368-1202
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100509349
MEDICAID GROUP #
NV
01
1497873475
NPI GROUP #
01
1891850459
NPI #
NV
01
V100640
MEDICARE GROUP #
Enumeration date
12/26/2006
Last updated
03/20/2009
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