Provider Demographics
NPI:1740021245
Name:CHRISTI ALSOP, DOM, LLC
Entity type:Organization
Organization Name:CHRISTI ALSOP, DOM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSOP
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-913-9556
Mailing Address - Street 1:1000 CORDOVA PL # 570
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1725
Mailing Address - Country:US
Mailing Address - Phone:505-913-9556
Mailing Address - Fax:
Practice Address - Street 1:228 S SAINT FRANCIS DR STE B
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2802
Practice Address - Country:US
Practice Address - Phone:505-913-9556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center