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General NPI Number Information
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NPI Number | 1417780941
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Entity Type | Organization
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Legal Business Name | ENSYNC HEALTH AND WELLNESS, LLC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 2101 GOLF COURSE RD SE STE C
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City | RIO RANCHO
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State | NM
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Zip | 87124-1760
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Country | US
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Telephone | 505-312-5765
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Fax | 888-981-4950
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Provider Business Mailing Address
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Address Line | 2101 GOLF COURSE RD SE STE C
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City | RIO RANCHO
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State | NM
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Zip | 87124-1760
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Country | US
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Telephone | 505-312-5765
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Fax | 888-981-4950
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Authorized Official
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Title or Position | OWNER/MEDICAL DIRECTOR
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Name | DR. JEREMY ROSS DURLING
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Credential | MD
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Telephone | 505-312-5765
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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