Provider Demographics
NPI:1669794475
Name:POND CHIROPRACTIC HEALTH CENTER, P. A.
Entity type:Organization
Organization Name:POND CHIROPRACTIC HEALTH CENTER, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:POND
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:505-325-5992
Mailing Address - Street 1:PO BOX 2332
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-2332
Mailing Address - Country:US
Mailing Address - Phone:505-325-5992
Mailing Address - Fax:505-327-5741
Practice Address - Street 1:2600 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-4507
Practice Address - Country:US
Practice Address - Phone:505-325-5992
Practice Address - Fax:505-327-5741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty