Individual
JEROME DE CASTRO BUENVIAJE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3600 RODEO LN, SUITE D-2, SANTA FE, NM 87507-6400
(505) 984-0821
(505) 984-0168
Mailing address
3600 RODEO LN, SUITE D-2, SANTA FE, NM 87507-6400
(505) 984-0821
(505) 984-0168
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1545
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019A24
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/15/2006
Last updated
07/08/2007
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