Provider Demographics
NPI:1841442456
Name:SPINE & MUSCLE TREATMENT CENTER
Entity type:Organization
Organization Name:SPINE & MUSCLE TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:CNMT, LMT
Authorized Official - Phone:505-822-8440
Mailing Address - Street 1:7007 JEFFERSON ST NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4450
Mailing Address - Country:US
Mailing Address - Phone:505-822-8440
Mailing Address - Fax:
Practice Address - Street 1:7007 JEFFERSON ST NE
Practice Address - Street 2:SUITE C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4450
Practice Address - Country:US
Practice Address - Phone:505-822-8440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMFA0083815174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty