Provider Demographics
NPI:1073164083
Name:PRECURE, MICHAEL STUART (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:STUART
Last Name:PRECURE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4904
Mailing Address - Country:US
Mailing Address - Phone:575-434-1455
Mailing Address - Fax:575-434-1007
Practice Address - Street 1:2001 10TH ST
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4904
Practice Address - Country:US
Practice Address - Phone:575-434-1455
Practice Address - Fax:575-434-1007
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDC2227111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor