Healthcare Provider Details

I. General information

NPI: 1417780941
Provider Name (Legal Business Name): ENSYNC HEALTH AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 GOLF COURSE RD SE STE C
RIO RANCHO NM
87124-1760
US

IV. Provider business mailing address

2101 GOLF COURSE RD SE STE C
RIO RANCHO NM
87124-1760
US

V. Phone/Fax

Practice location:
  • Phone: 505-312-5765
  • Fax: 888-981-4950
Mailing address:
  • Phone: 505-312-5765
  • Fax: 888-981-4950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEREMY ROSS DURLING
Title or Position: OWNER/MEDICAL DIRECTOR
Credential: MD
Phone: 505-312-5765