Healthcare Provider Details

I. General information

NPI: 1356589477
Provider Name (Legal Business Name): LYNNA M LIES DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 MONTGOMERY BLVD NE BLDG E9
ALBUQUERQUE NM
87109-1554
US

IV. Provider business mailing address

8008 BASALT AVE NW
ALBUQUERQUE NM
87120-6534
US

V. Phone/Fax

Practice location:
  • Phone: 505-581-0881
  • Fax:
Mailing address:
  • Phone: 505-581-0881
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIA 1349
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-2026-0024
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH60058655
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: