Healthcare Provider Details

I. General information

NPI: 1992072243
Provider Name (Legal Business Name): PATRICK OKEEFE CHIROPRACTIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 LUISA ST STE A
SANTA FE NM
87505-4073
US

IV. Provider business mailing address

1421 LUISA ST STE A
SANTA FE NM
87505-4073
US

V. Phone/Fax

Practice location:
  • Phone: 505-983-4225
  • Fax: 505-983-7256
Mailing address:
  • Phone: 505-983-4225
  • Fax: 505-983-7256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1549
License Number StateNM

VIII. Authorized Official

Name: DR. PATRICK J OKEEFE
Title or Position: PRESIDENT
Credential: DC
Phone: 505-983-4225