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General NPI Number Information
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NPI Number | 1336307164
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Entity Type | Organization
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Legal Business Name | HEALING ARTS CHIROPRACTIC AND NUTRITION CENTER
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 2105 GOLF COURSE RD SE SUITE C
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City | RIO RANCHO
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State | NM
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Zip | 87124-1626
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Country | US
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Telephone | 505-220-3031
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Fax | 505-896-3242
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Provider Business Mailing Address
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Address Line | 2105 GOLF COURSE RD SE SUITE C
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City | RIO RANCHO
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State | NM
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Zip | 87124-1626
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Country | US
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Telephone | 505-220-3031
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Fax | 505-896-3242
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. LATHY LYNN PHILLIPS
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Credential | DC
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Telephone | 505-220-3031
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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 | 1532
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License Number State | NM
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