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General NPI Number Information
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NPI Number | 1235120502
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Entity Type | Organization
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Legal Business Name | ALIGNMENT OF LIFE INC
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 06/16/2011
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Provider Practice Location Address
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Address Line | 2019 GALISTEO ST UNIT E-2
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City | SANTA FE
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State | NM
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Zip | 87505-2143
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Country | US
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Telephone | 505-982-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 2019 GALISTEO ST UNIT E-2
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City | SANTA FE
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State | NM
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Zip | 87505-2143
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Country | US
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Telephone | 505-982-6886
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Fax |
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Authorized Official
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Title or Position | OWNER AGENT
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Name | MR. BOBBY O PEREA
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Credential | DC
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Telephone | 505-982-6886
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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 | 1480
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License Number State | NM
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