Provider Demographics
NPI:1487759551
Name:QUALICARE CHIROPRACTIC BRIGGS, FREERKSEN, LTD.
Entity type:Organization
Organization Name:QUALICARE CHIROPRACTIC BRIGGS, FREERKSEN, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:C-JO
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:702-385-3090
Mailing Address - Street 1:1736 E CHARLESTON BLVD
Mailing Address - Street 2:PMB 255
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-7900
Mailing Address - Country:US
Mailing Address - Phone:702-385-3090
Mailing Address - Fax:702-407-3076
Practice Address - Street 1:1736 E CHARLESTON BLVD
Practice Address - Street 2:PMB 255
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-7900
Practice Address - Country:US
Practice Address - Phone:702-385-3090
Practice Address - Fax:702-407-3076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty