Healthcare Provider Details

I. General information

NPI: 1124133202
Provider Name (Legal Business Name): ARJAN KAUR KHALSA D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6020 CONSTITUTION AVE NE STE 1
ALBUQUERQUE NM
87110-5931
US

IV. Provider business mailing address

3610 CALLE DEL SOL NE
ALBUQUERQUE NM
87110-6112
US

V. Phone/Fax

Practice location:
  • Phone: 505-819-3626
  • Fax:
Mailing address:
  • Phone: 505-819-3626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1476
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: