MEDICARE: DR. LAURA RODRIGUEZ D.C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	1659	NM

General Provider Information

NPI Number	:	1083715130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURA RODRIGUEZ D.C

Provider Business Mailing Address
First Line	:	1705 N VALLEY DR
Second Line	:	SUITE 4
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-5121
Country	:	US
Telephone Number	:	575-527-5083
Fax Number	:	575-527-5093

Provider Business Practice Location Address
First Line	:	1705 NORTH VALLEY DRIVE
Second Line	:	SUITE 4
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-5121
Country	:	US
Telephone Number	:	575-527-5083
Fax Number	:	575-527-5093

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	06/10/2008

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