Provider Demographics
NPI:1669678884
Name:BONES INC
Entity Type:Organization
Organization Name:BONES INC
Other - Org Name:MESILLA VALLEY CHIROPRACTIC CENTER - RIO GRANDE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:M
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:575-522-8085
Mailing Address - Street 1:755 TELSHOR BLVD
Mailing Address - Street 2:#102-B
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4686
Mailing Address - Country:US
Mailing Address - Phone:575-522-8085
Mailing Address - Fax:575-522-8086
Practice Address - Street 1:755 TELSHOR BLVD
Practice Address - Street 2:#102-B
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4686
Practice Address - Country:US
Practice Address - Phone:575-522-8085
Practice Address - Fax:575-522-8086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM569111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMT40867Medicare UPIN