Provider Demographics
NPI:1295814804
Name:PURCARO, LEE FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:FRANCIS
Last Name:PURCARO
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 1:9004 MENAUL BLVD NE
Mailing Address - Street 2:SUITE #9
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-2259
Mailing Address - Country:US
Mailing Address - Phone:505-275-1090
Mailing Address - Fax:505-275-1090
Practice Address - Street 1:9004 MENAUL BLVD NE
Practice Address - Street 2:SUITE #9
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2259
Practice Address - Country:US
Practice Address - Phone:505-275-1090
Practice Address - Fax:505-275-1090
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1242111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMNM00KA52OtherBLUE CROSS BLUE SHIELD NM
7761242OtherAETNA
7761242OtherAETNA