Healthcare Provider Details

I. General information

NPI: 1639199847
Provider Name (Legal Business Name): FLOYD PATRICK HALE III DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 MENAUL NE
ALBUQUERQUE NM
87110
US

IV. Provider business mailing address

7100 MENAUL NE
ALBUQUERQUE NM
87110
US

V. Phone/Fax

Practice location:
  • Phone: 505-883-6420
  • Fax: 505-888-7967
Mailing address:
  • Phone: 505-883-6420
  • Fax: 505-888-7967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number537
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: