Healthcare Provider Details

I. General information

NPI: 1508256611
Provider Name (Legal Business Name): CHRISTINA M LUJAN DC, CCSP, AT, CKTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2015
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 OSUNA RD NE STE 600
ALBUQUERQUE NM
87113-0009
US

IV. Provider business mailing address

701 OSUNA RD NE SUITE 600
ALBUQUERQUE NM
87113-1384
US

V. Phone/Fax

Practice location:
  • Phone: 505-508-2369
  • Fax: 505-508-2523
Mailing address:
  • Phone: 505-508-2369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC2088
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number5737
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: