Healthcare Provider Details

I. General information

NPI: 1770703837
Provider Name (Legal Business Name): ROSENGREN CHIROPRACTIC & ACUPUNCTURE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 GARFIELD STREET
SANTA FE NM
87501
US

IV. Provider business mailing address

310 GARFIELD STREET
SANTA FE NM
87501
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 Code171100000X
TaxonomyAcupuncturist
License Number178 ACUPUNCTURE
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number807 CHIROPACTIC
License Number StateNM

VIII. Authorized Official

Name: DR. DAVID ROSENGREN
Title or Position: PRESIDENT
Credential: D.C., DOM
Phone: 505-983-1513