Provider Demographics
NPI:1336473396
Name:VELASQUEZ, ADRIAN FERMIN
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:FERMIN
Last Name:VELASQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5941 JEFFERSON ST NE STE B
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3409
Mailing Address - Country:US
Mailing Address - Phone:505-323-7560
Mailing Address - Fax:505-323-7561
Practice Address - Street 1:5941 JEFFERSON ST NE STE B
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3409
Practice Address - Country:US
Practice Address - Phone:505-323-7560
Practice Address - Fax:505-323-7561
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1754111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor