Provider Demographics
NPI:1033475561
Name:REFORM SPINE & INJURY CARE CENTER
Entity Type:Organization
Organization Name:REFORM SPINE & INJURY CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE
Authorized Official - Prefix:MS
Authorized Official - First Name:BABETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-821-4325
Mailing Address - Street 1:7007 JEFFERSON ST NE STE C
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4450
Mailing Address - Country:US
Mailing Address - Phone:505-821-4325
Mailing Address - Fax:505-822-8460
Practice Address - Street 1:7007 JEFFERSON ST NE STE C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4450
Practice Address - Country:US
Practice Address - Phone:505-821-4325
Practice Address - Fax:505-822-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMFA0087702261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine