Provider Demographics
NPI:1659340644
Name:HITE, LINDA R (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:R
Last Name:HITE
Suffix:
Gender:F
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:PO BOX 3515
Mailing Address - Street 2:
Mailing Address - City:GALLUP
Mailing Address - State:NM
Mailing Address - Zip Code:87305-3515
Mailing Address - Country:US
Mailing Address - Phone:505-862-1962
Mailing Address - Fax:
Practice Address - Street 1:1808 E AZTEC AVE
Practice Address - Street 2:SUITE #7
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-4946
Practice Address - Country:US
Practice Address - Phone:505-722-3979
Practice Address - Fax:505-722-6040
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1613111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM92390OtherPRESBYTERIAN - NEW MEXICO
NMNM00KJ72OtherBLUECROSS BLUESHIELD