Organization
HILLIARD CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM KENT HILLIARD DC (OWNER)
(505) 356-6982
Entity
Organization
Contact information
Practice address
112 E 4TH ST, PORTALES, NM 88130-6305
(505) 356-6982
(505) 356-3773
Mailing address
112 E 4TH ST, PORTALES, NM 88130-6305
(505) 356-6982
(505) 356-3773
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
480
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000K737
—
NM
01
—
K860
BLUECROSS/BLUESHIELD
NM
Enumeration date
10/03/2007
Last updated
10/03/2007
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