Healthcare Provider Details

I. General information

NPI: 1962553511
Provider Name (Legal Business Name): JAMES E. BARE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8005 MARBLE AVE NE
ALBUQUERQUE NM
87110-7901
US

IV. Provider business mailing address

8005 MARBLE AVE NE
ALBUQUERQUE NM
87110-7901
US

V. Phone/Fax

Practice location:
  • Phone: 505-268-4272
  • Fax: 505-268-4064
Mailing address:
  • Phone: 505-268-4272
  • Fax: 505-268-4064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number539
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: