Provider Demographics
NPI:1437447497
Name:B -FIT CHIROPRACTIC
Entity Type:Organization
Organization Name:B -FIT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZARUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-662-1905
Mailing Address - Street 1:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-0339
Mailing Address - Country:US
Mailing Address - Phone:505-662-1905
Mailing Address - Fax:505-662-1905
Practice Address - Street 1:3500 TRINITY DR
Practice Address - Street 2:SUITE A-5
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-1775
Practice Address - Country:US
Practice Address - Phone:505-662-1905
Practice Address - Fax:505-662-1905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty