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Individual

DR. SCOTT OWEN WASHBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
421 S AVENUE C, SUITE C, PORTALES, NM 88130-6328
(575) 799-0955
Mailing address
PO BOX 1314, PORTALES, NM 88130-1314
(575) 799-0955

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2129
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350024807
RR MC
NM
Enumeration date
06/22/2005
Last updated
11/03/2015
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