Provider Demographics
NPI:1336681840
Name:MUSCULOSKELETAL SPECIALISTS
Entity Type:Organization
Organization Name:MUSCULOSKELETAL SPECIALISTS
Other - Org Name:MUSCULOSKELETAL MEDICINE OF NEW MEXICO
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NAPRAPATH
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DN
Authorized Official - Phone:505-412-4061
Mailing Address - Street 1:3500 TRINITY DR STE C5
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2221
Mailing Address - Country:US
Mailing Address - Phone:505-412-4061
Mailing Address - Fax:
Practice Address - Street 1:3500 TRINITY DR STE C5
Practice Address - Street 2:
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2221
Practice Address - Country:US
Practice Address - Phone:505-412-4061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No172P00000XOther Service ProvidersNaprapathGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty