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NPI Code Detail

MEDICARE: NEW DIRECTION CHIROPRACTIC, LLC

MEDICARE: NEW DIRECTION CHIROPRACTIC, LLC
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
1111N00000XChiropractor

General Provider Information

NPI Number : 1144544347
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW DIRECTION CHIROPRACTIC, LLC
Provider Business Mailing Address
First Line : 3216 MONTE VISTA BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-2120
Country : US
Telephone Number : 505-247-4325
Fax Number : 505-247-4326
Provider Business Practice Location Address
First Line : 3216 MONTE VISTA BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-2120
Country : US
Telephone Number : 505-247-4325
Fax Number : 505-247-4326
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : JAMES M VANDERLOOP
Credential : D.C.
Telephone Number : 505-247-4325
Provider Enumeration Date : 03/17/2010
Last Update Date : 09/28/2018

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Directions to “NEW DIRECTION CHIROPRACTIC, LLC ” Practice Location

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