Provider Demographics
NPI:1548431554
Name:FAMILY WELLNESS CHIROPRACTIC CENTER
Entity Type:Organization
Organization Name:FAMILY WELLNESS CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SLEEKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-393-4636
Mailing Address - Street 1:1010 N DALMONT
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-5218
Mailing Address - Country:US
Mailing Address - Phone:575-393-4636
Mailing Address - Fax:575-393-6927
Practice Address - Street 1:1010 N DALMONT
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-5218
Practice Address - Country:US
Practice Address - Phone:575-393-4636
Practice Address - Fax:575-393-6927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM800521013Medicare PIN