Healthcare Provider Details

I. General information

NPI: 1679740450
Provider Name (Legal Business Name): RUBEN RAMIREZ JR. DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 ADAMS SE
ALBUQUERQUE NM
87108
US

IV. Provider business mailing address

316 ADAMS SE
ALBUQUERQUE NM
87108
US

V. Phone/Fax

Practice location:
  • Phone: 505-247-2373
  • Fax: 505-243-4455
Mailing address:
  • Phone: 505-247-2373
  • Fax: 505-243-4455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1394
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: