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General NPI Number Information
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NPI Number | 1760677207
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Entity Type | Organization
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Legal Business Name | ADVANCED MOVEMENT CHIROPRACTIC INC.
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 2620 SAN MATEO BLVD NE STE F
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3163
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Country | US
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Telephone | 505-888-4044
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Fax | 505-888-1932
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Provider Business Mailing Address
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Address Line | 5301 FEATHER ROCK PL NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-4197
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Country | US
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Telephone | 505-301-8439
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Fax | 888-677-9456
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM V TRABOLD
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Credential | D.C
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Telephone | 505-301-8439
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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 | NM00KJ55
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License Number State | NM
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