Provider Demographics
NPI:1275821233
Name:INFINITE HEALTH CHIROPRACTIC WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:INFINITE HEALTH CHIROPRACTIC WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:DOOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-325-2010
Mailing Address - Street 1:904 E 20TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-4281
Mailing Address - Country:US
Mailing Address - Phone:505-325-2010
Mailing Address - Fax:
Practice Address - Street 1:904 E 20TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-4281
Practice Address - Country:US
Practice Address - Phone:505-325-2010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1891111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty