Healthcare Provider Details

I. General information

NPI: 1730401225
Provider Name (Legal Business Name): MICHAEL M FINNEGAN DOM, LMT, CMTPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4103 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1102
US

IV. Provider business mailing address

5115 COORS BLVD NW STE E
ALBUQUERQUE NM
87120-1926
US

V. Phone/Fax

Practice location:
  • Phone: 505-830-3585
  • Fax:
Mailing address:
  • Phone: 505-897-6560
  • Fax: 505-715-5537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number5954
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1221
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: