Provider Demographics
NPI:1235120502
Name:ALIGNMENT OF LIFE INC
Entity Type:Organization
Organization Name:ALIGNMENT OF LIFE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:O
Authorized Official - Last Name:PEREA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-982-6886
Mailing Address - Street 1:2019 GALISTEO ST
Mailing Address - Street 2:UNIT E-2
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2143
Mailing Address - Country:US
Mailing Address - Phone:505-982-6886
Mailing Address - Fax:
Practice Address - Street 1:2019 GALISTEO ST
Practice Address - Street 2:UNIT E-2
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-2143
Practice Address - Country:US
Practice Address - Phone:505-982-6886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-04
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1480111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM331429504Medicare PIN
U85770Medicare UPIN