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Individual

KENNETH P. SOULSBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
909 SOUTH GOLD AVE, DEMING, NM 88030-4754
(575) 546-7331
(575) 546-5380
Mailing address
909 SOUTH GOLD AVE, DEMING, NM 88030-4754
(575) 546-7331
(575) 546-5380

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
3800
AZ
111N00000X
Chiropractor
Primary
839
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00132383
RAILROAD MEDICARE PIN
NM
Enumeration date
09/27/2006
Last updated
10/20/2010
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