Healthcare Provider Details

I. General information

NPI: 1679601835
Provider Name (Legal Business Name): PRECURE CHIROPRACTIC CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 EAST 10TH STREET
ALAMOGORDO NM
88310-4904
US

IV. Provider business mailing address

2001 EAST 10TH STREET
ALAMOGORDO NM
88310-4904
US

V. Phone/Fax

Practice location:
  • Phone: 575-434-1455
  • Fax: 575-443-1007
Mailing address:
  • Phone: 575-434-1455
  • Fax: 575-443-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1632
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License Number1632
License Number StateNM

VIII. Authorized Official

Name: DR. MICHAEL R PRECURE
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 575-434-1455