Healthcare Provider Details

I. General information

NPI: 1083785745
Provider Name (Legal Business Name): DAVID ROSENGREN D.C., D.O.M
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 GARFIELD ST
SANTA FE NM
87501-2612
US

IV. Provider business mailing address

310 GARFIELD ST
SANTA FE NM
87501-2612
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-1513
  • Fax: 505-983-2215
Mailing address:
  • Phone: 505-983-1513
  • Fax: 505-983-2215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number807
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number178
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: