Healthcare Provider Details

I. General information

NPI: 1396922662
Provider Name (Legal Business Name): LAURA LYNN HOBSON-SHOEMAKER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 06/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 MENAUL BLVD NE SUITE A
ALBUQUERQUE NM
87112-2455
US

IV. Provider business mailing address

10900 MENAUL BLVD NE SUITE A
ALBUQUERQUE NM
87112-2455
US

V. Phone/Fax

Practice location:
  • Phone: 505-271-8888
  • Fax: 505-292-3181
Mailing address:
  • Phone: 505-271-8888
  • Fax: 505-292-3181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1530
License Number StateNM

VIII. Authorized Official

Name: DR. LAURA LYNN HOBSON-SHOEMAKER
Title or Position: OWNER
Credential:
Phone: 505-271-8888