Organization
COLONIAS CHIROPRACTIC CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCY WHYTE FERGUSON D.C. (OWNER)
(505) 776-1117
Entity
Organization
Contact information
Practice address
98 STATE HWY 150 SUITE #7, EL PRADO, NM 87529
(575) 776-1117
(575) 776-1119
Mailing address
PO BOX 1589, EL PRADO, NM 87529-1589
(575) 776-1117
(575) 776-1119
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1149
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM01KB78
BLUE CROSS BLUE SHIELD
NM
Enumeration date
05/09/2007
Last updated
07/21/2010
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