Healthcare Provider Details

I. General information

NPI: 1376197178
Provider Name (Legal Business Name): FAMILY CHIROPRACTIC CENTER OF SANTA FE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 GALISTEO ST STE M6
SANTA FE NM
87505-2106
US

IV. Provider business mailing address

2019 GALISTEO ST STE M6
SANTA FE NM
87505-2106
US

V. Phone/Fax

Practice location:
  • Phone: 505-984-0006
  • Fax: 855-471-3778
Mailing address:
  • Phone: 505-984-0006
  • Fax: 855-471-3778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHEN PERLSTEIN
Title or Position: OWNER
Credential: DC
Phone: 505-984-0006