Healthcare Provider Details

I. General information

NPI: 1992291850
Provider Name (Legal Business Name): REINECKE MEDICAL AND CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2018
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E COLLEGE BLVD STE E
ROSWELL NM
88201-7570
US

IV. Provider business mailing address

602 E COLLEGE BLVD
ROSWELL NM
88201-7529
US

V. Phone/Fax

Practice location:
  • Phone: 575-623-3155
  • Fax: 575-623-3677
Mailing address:
  • Phone: 575-623-3155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRASIMIR HRISTOV
Title or Position: OWNER
Credential: NP
Phone: 773-837-0915