Healthcare Provider Details

I. General information

NPI: 1609506062
Provider Name (Legal Business Name): THE BACKBONE - NAPRAPATHIC REHAB CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2022
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4015 CARLISLE BLVD NE STE A
ALBUQUERQUE NM
87107-4529
US

IV. Provider business mailing address

4015 CARLISLE BLVD NE STE A
ALBUQUERQUE NM
87107-4529
US

V. Phone/Fax

Practice location:
  • Phone: 505-591-6277
  • Fax: 505-508-0932
Mailing address:
  • Phone: 505-591-6277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number
License Number State

VIII. Authorized Official

Name: DR. ROZEE G BENAVIDES
Title or Position: CO-OWNER, NAPRAPATH
Credential: DN
Phone: 505-591-6277