Provider Demographics
NPI:1407843170
Name:GARNER, CURTIS LEN (DC)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:LEN
Last Name:GARNER
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 1:2003 SOUTHERN BLVD SE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-3751
Mailing Address - Country:US
Mailing Address - Phone:505-892-2222
Mailing Address - Fax:505-892-1056
Practice Address - Street 1:2003 SOUTHERN BLVD SE
Practice Address - Street 2:SUITE 109
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3751
Practice Address - Country:US
Practice Address - Phone:505-892-2222
Practice Address - Fax:505-892-1056
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM2-67061-8Medicare ID - Type Unspecified