Provider Demographics
NPI:1801785498
Name:FLORES, NATHANIEL (DC)
Entity type:Individual
Prefix:DR
First Name:NATHANIEL
Middle Name:
Last Name:FLORES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 SR 268
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:NM
Mailing Address - Zip Code:88124-9453
Mailing Address - Country:US
Mailing Address - Phone:575-495-9034
Mailing Address - Fax:
Practice Address - Street 1:1300 SR 268
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:NM
Practice Address - Zip Code:88124-9453
Practice Address - Country:US
Practice Address - Phone:575-495-9034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor