Healthcare Provider Details

I. General information

NPI: 1013370493
Provider Name (Legal Business Name): ANDREW LANGFITT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 04/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 E BENDER BLVD
HOBBS NM
88240-2415
US

IV. Provider business mailing address

4809 BASIN ST NE
ALBUQUERQUE NM
87111-2712
US

V. Phone/Fax

Practice location:
  • Phone: 575-408-3295
  • Fax:
Mailing address:
  • Phone: 575-408-3295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number1944
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: