David C Ketchum in Las Vegas - Sports Physician
David C Ketchum - NPI 1467458067
David C Ketchum is a Sports Physician in Las Vegas, Nevada. David C Ketchum practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for David C Ketchum is 1467458067. The last update date is 2007-07-09.
David C Ketchum's current location address is 2647 Box Canyon Dr, Las Vegas, Nevada. You can contact this provider via phone number 7023635575 and fax number 7026461727. The mailing address for David C Ketchum is 2647 Box Canyon Dr, Las Vegas, Nevada. To know further, please read the information below!
Provider Profile Detail
| Provider Name | David C Ketchum |
|---|---|
| Address | 2647 Box Canyon Dr, Las Vegas, Nevada |
| Phone Number | 7023635575 |
| Fax Number | 7026461727 |
| Sole Proprietor | X |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1467458067 |
|---|---|
| Provider Enumeration Date | 2005-06-28 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 2647 Box Canyon Dr |
|---|---|
| City | Las Vegas |
| State | Nevada (NV) |
| Post Code | 891280450 |
| Phone Number | 7023635575 |
| Fax Number | 7026461727 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | B842 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| B842 | NV | CHIR BD OF NV LICENSE |
Post Comment/ Review Below
What is the David C Ketchum's unique identification number?
The David C Ketchum has been assigned the NPI (National Provider Identifier) Number 1467458067 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where David C Ketchum is geographically located?
The David C Ketchum is physically situated at the following location: 2647 Box Canyon Dr, Las Vegas, NV, 891280450.
What is the David C Ketchum's area of specialization and corresponding taxonomy classification?
The David C Ketchum's specialty field is Sports Physician, and it falls under the taxonomy code 111Ns0005X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1467458067 to David C Ketchum?
The Centers for Medicare & Medicaid Services originally issued the 1467458067 to David C Ketchum on 2005-06-28.
As of what date were the details pertaining to David C Ketchum last refreshed?
The information related to the David C Ketchum, including its address, specialty, and other relevant details, was last updated on 2007-07-09.