Provider Demographics
NPI:1235399668
Name:RODRIGUEZ FAMILY CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:RODRIGUEZ FAMILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:575-527-5083
Mailing Address - Street 1:1705 N VALLEY DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-5121
Mailing Address - Country:US
Mailing Address - Phone:575-527-5083
Mailing Address - Fax:575-527-5093
Practice Address - Street 1:1705 N VALLEY DR
Practice Address - Street 2:SUITE 4
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-5121
Practice Address - Country:US
Practice Address - Phone:575-527-5083
Practice Address - Fax:575-527-5093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty