Provider Demographics
NPI:1174751713
Name:VIGIL, JOHN H (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:VIGIL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7465 W LAKE MEAD BLVD
Mailing Address - Street 2:STE. 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-1032
Mailing Address - Country:US
Mailing Address - Phone:702-562-1244
Mailing Address - Fax:702-562-1245
Practice Address - Street 1:7465 W LAKE MEAD BLVD
Practice Address - Street 2:STE. 115
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-1032
Practice Address - Country:US
Practice Address - Phone:702-562-1244
Practice Address - Fax:702-562-1245
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01348111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor