Provider Demographics
NPI:1821427261
Name:DESERT MOTIONS CHIROPRACTIC
Entity Type:Organization
Organization Name:DESERT MOTIONS CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-883-1011
Mailing Address - Street 1:1201 EUBANK BLVD NE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-5386
Mailing Address - Country:US
Mailing Address - Phone:505-883-1101
Mailing Address - Fax:505-883-0629
Practice Address - Street 1:1201 EUBANK BLVD NE
Practice Address - Street 2:SUITE 6
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-5386
Practice Address - Country:US
Practice Address - Phone:505-883-1101
Practice Address - Fax:505-883-0629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2074111N00000X, 261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty