Provider Demographics
NPI:1669608907
Name:THE HEALTH DOC, LLC
Entity type:Organization
Organization Name:THE HEALTH DOC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-275-9809
Mailing Address - Street 1:9809 CANDELARIA RD NE BLDG 3
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-1458
Mailing Address - Country:US
Mailing Address - Phone:505-275-9809
Mailing Address - Fax:505-275-9801
Practice Address - Street 1:9809 CANDELARIA RD NE BLDG 3
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1458
Practice Address - Country:US
Practice Address - Phone:505-275-9809
Practice Address - Fax:505-275-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1340111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty