Healthcare Provider Details

I. General information

NPI: 1255485082
Provider Name (Legal Business Name): PEER CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 MONTGOMERY BLVD NE SUITE D-10
ALBUQUERQUE NM
87109-1521
US

IV. Provider business mailing address

7520 MONTGOMERY BLVD NE SUITE D-10
ALBUQUERQUE NM
87109-1521
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-9616
  • Fax: 505-888-8836
Mailing address:
  • Phone: 505-888-9616
  • Fax: 808-888-8836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1499
License Number StateNM

VIII. Authorized Official

Name: DR. DAVID WILLIAM PEER
Title or Position: PRESIDENT
Credential: DC, CCSP
Phone: 505-888-9616