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General NPI Number Information
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NPI Number | 1598958860
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Entity Type | Organization
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Legal Business Name | ACCIDENT BACK & NECK CARE CENTER, INC
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 1110 PENNSYLVANIA NE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7404
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Country | US
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Telephone | 505-268-0808
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Fax | 505-268-2458
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Provider Business Mailing Address
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Address Line | 1110 PENNSYLVANIA ST NE SUITE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-7402
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Country | US
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Telephone | 505-268-0808
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Fax | 505-268-2458
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT E. BYRD
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Credential | D.C.
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Telephone | 505-268-0808
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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 | NM1009
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License Number State | NM
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