Healthcare Provider Details

I. General information

NPI: 1295814804
Provider Name (Legal Business Name): LEE FRANCIS PURCARO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9004 MENAUL BLVD NE SUITE #9
ALBUQUERQUE NM
87112-2259
US

IV. Provider business mailing address

9004 MENAUL BLVD NE SUITE #9
ALBUQUERQUE NM
87112-2259
US

V. Phone/Fax

Practice location:
  • Phone: 505-275-1090
  • Fax: 505-275-1090
Mailing address:
  • Phone: 505-275-1090
  • Fax: 505-275-1090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1242
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: