Healthcare Provider Details

I. General information

NPI: 1720121502
Provider Name (Legal Business Name): SCOTT M DELPRETE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 12/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 MENAUL BLVD NE
ALBUQUERQUE NM
87110-3688
US

IV. Provider business mailing address

7100 MENAUL BLVD NE
ALBUQUERQUE NM
87110-3688
US

V. Phone/Fax

Practice location:
  • Phone: 505-883-5858
  • Fax: 505-883-0010
Mailing address:
  • Phone: 505-883-5858
  • Fax: 505-883-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1732
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: