Provider Demographics
NPI:1609038967
Name:UNIIFIED CHIROPRACTIC
Entity Type:Organization
Organization Name:UNIIFIED CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:HIRNING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-831-1115
Mailing Address - Street 1:3301 COORS BLVD NW
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1229
Mailing Address - Country:US
Mailing Address - Phone:505-831-1115
Mailing Address - Fax:505-831-3625
Practice Address - Street 1:3301 COORS BLVD NW
Practice Address - Street 2:SUITE D
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1229
Practice Address - Country:US
Practice Address - Phone:505-831-1115
Practice Address - Fax:505-831-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM348514401Medicare PIN