Healthcare Provider Details

I. General information

NPI: 1144544347
Provider Name (Legal Business Name): NEW DIRECTION CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 MONTE VISTA BLVD NE
ALBUQUERQUE NM
87106-2120
US

IV. Provider business mailing address

3216 MONTE VISTA BLVD NE
ALBUQUERQUE NM
87106-2120
US

V. Phone/Fax

Practice location:
  • Phone: 505-247-4325
  • Fax: 505-247-4326
Mailing address:
  • Phone: 505-247-4325
  • Fax: 505-247-4326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JAMES M VANDERLOOP
Title or Position: PRESIDENT/OWNER
Credential: D.C.
Phone: 505-247-4325