Healthcare Provider Details
I. General information
NPI: 1972636231
Provider Name (Legal Business Name): LIFETIME CHIROPRACTIC UNIT 2 PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7007 WYOMING BLVD NE SUITE E2
ALBUQUERQUE NM
87109
US
IV. Provider business mailing address
7007 WYOMING BLVD NE SUITE E2
ALBUQUERQUE NM
87109
US
V. Phone/Fax
- Phone: 505-822-0306
- Fax:
- Phone: 505-822-0306
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 1079 |
| License Number State | NM |
VIII. Authorized Official
Name: DR.
PATRICK
CHRISTOPHER
CHENOWETH
Title or Position: OWNER/PC
Credential: DC
Phone: 505-822-0306