Provider Demographics
NPI:1770703837
Name:ROSENGREN CHIROPRACTIC & ACUPUNCTURE LLC
Entity type:Organization
Organization Name:ROSENGREN CHIROPRACTIC & ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENGREN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DOM
Authorized Official - Phone:505-983-1513
Mailing Address - Street 1:310 GARFIELD STREET
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501
Mailing Address - Country:US
Mailing Address - Phone:505-983-1513
Mailing Address - Fax:505-983-2215
Practice Address - Street 1:310 GARFIELD STREET
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501
Practice Address - Country:US
Practice Address - Phone:505-983-1513
Practice Address - Fax:505-983-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM178 ACUPUNCTURE171100000X
NM807 CHIROPACTIC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty