1033458146 NPI number — CHIROPRACTIC CARING FOR YOU LLC

Table of content: (NPI 1033458146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033458146 NPI number — CHIROPRACTIC CARING FOR YOU LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHIROPRACTIC CARING FOR YOU LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EDWARD WADE RICHARDSON SOLE MEMBER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033458146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2151 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS CRUCES
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88001-1128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-524-0400
Provider Business Mailing Address Fax Number:
575-524-0595

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2151 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS CRUCES
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88001-1128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-524-0400
Provider Business Practice Location Address Fax Number:
575-524-0595
Provider Enumeration Date:
02/08/2013

Additional Information

Authorized Official

Authorized Official Last Name:
RICHARDSON
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
WADE
Authorized Official Title or Position:
SOLE OWNER
Authorized Official Telephone Number:
575-524-0400

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , with the licence number:  962 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com