Healthcare Provider Details

I. General information

NPI: 1114108339
Provider Name (Legal Business Name): SUSAN M BRIGHT DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 11/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 S ST FRANCIS DR
SANTA FE NM
87505
US

IV. Provider business mailing address

1504 S ST FRANCIS DR
SANTA FE NM
87505
US

V. Phone/Fax

Practice location:
  • Phone: 505-984-1222
  • Fax: 505-984-1376
Mailing address:
  • Phone: 505-984-1222
  • Fax: 505-984-1376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number844
License Number StateNM

VIII. Authorized Official

Name: DR. SUSAN MAE BRIGHT
Title or Position: PRESIDENT CHIROPRACTOR
Credential: DC
Phone: 505-984-1222