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General NPI Number Information
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NPI Number | 1669794475
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Entity Type | Organization
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Legal Business Name | POND CHIROPRACTIC HEALTH CENTER, P. A.
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Dates
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Enumeration Date | 02/20/2010
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Last Update Date | 02/20/2010
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Provider Practice Location Address
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Address Line | 2600 FARMINGTON AVE
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City | FARMINGTON
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State | NM
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Zip | 87401-4507
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Country | US
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Telephone | 505-325-5992
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Fax | 505-327-5741
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Provider Business Mailing Address
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Address Line | PO BOX 2332
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City | FARMINGTON
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State | NM
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Zip | 87499-2332
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Country | US
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Telephone | 505-325-5992
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Fax | 505-327-5741
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LONNIE L POND
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Credential | D. C.
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Telephone | 505-325-5992
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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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