Healthcare Provider Details

I. General information

NPI: 1427363662
Provider Name (Legal Business Name): V CHIROPRACTIC AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2010
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 5TH ST SUITE 12
SANTA FE NM
87505-3480
US

IV. Provider business mailing address

541 GARCIA ST
SANTA FE NM
87505-2855
US

V. Phone/Fax

Practice location:
  • Phone: 505-795-3337
  • Fax:
Mailing address:
  • Phone: 505-795-3337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6328
License Number StateCO

VIII. Authorized Official

Name: DR. MICHAEL S VARNAY
Title or Position: OWNER
Credential: DC
Phone: 303-728-4855