Healthcare Provider Details

I. General information

NPI: 1225237258
Provider Name (Legal Business Name): ANN MARIE GLAVEY D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 07/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 SIERRA VISTA CT NE SUITE A
ALBUQUERQUE NM
87111-3461
US

IV. Provider business mailing address

9601 SIERRA VISTA CT NE SUITE A
ALBUQUERQUE NM
87111-3461
US

V. Phone/Fax

Practice location:
  • Phone: 505-908-0665
  • Fax: 505-275-8505
Mailing address:
  • Phone: 505-908-0665
  • Fax: 505-275-8505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number8022
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: