Provider Demographics
NPI:1487797478
Name:COLAN, KEVIN P (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:P
Last Name:COLAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1301 CRYSTAL MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1472
Mailing Address - Country:US
Mailing Address - Phone:702-254-2394
Mailing Address - Fax:702-562-2499
Practice Address - Street 1:7488 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-2740
Practice Address - Country:US
Practice Address - Phone:702-562-0652
Practice Address - Fax:702-562-2499
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVB295111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor