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General NPI Number Information
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NPI Number | 1053646463
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Entity Type | Organization
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Legal Business Name | NOSEFF FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/03/2009
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Last Update Date | 12/14/2009
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Provider Practice Location Address
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Address Line | 2410 N FOWLER ST STE. A
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City | HOBBS
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State | NM
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Zip | 88240-2312
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Country | US
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Telephone | 575-492-1502
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Fax |
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Provider Business Mailing Address
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Address Line | 2410 N FOWLER ST STE. A
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City | HOBBS
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State | NM
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Zip | 88240-2312
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Country | US
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Telephone | 575-492-1502
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JERRIED LEE NOSEFF
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Credential | D.C.
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Telephone | 575-492-1502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1755
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License Number State | NM
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