Healthcare Provider Details

I. General information

NPI: 1013388362
Provider Name (Legal Business Name): HONU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8004 PENNSYLVANIA CIR NE
ALBUQUERQUE NM
87110-7824
US

IV. Provider business mailing address

8004 PENNSYLVANIA CIR NE
ALBUQUERQUE NM
87110-7824
US

V. Phone/Fax

Practice location:
  • Phone: 505-265-5651
  • Fax: 505-265-8671
Mailing address:
  • Phone: 505-265-5651
  • Fax: 505-265-8671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1651
License Number StateNM

VIII. Authorized Official

Name: DEREK S ATCHLEY
Title or Position: OWNER
Credential: DC
Phone: 505-265-5651