Organization
JAN C JAY DOM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN C JAY DOM (PRESIDENT)
(505) 323-8100
Entity
Organization
Contact information
Practice address
11110 SAN RAFAEL AVE NE, ALBUQUERQUE, NM 87122-2400
(505) 323-8100
Mailing address
11110 SAN RAFAEL AVE NE, ALBUQUERQUE, NM 87122-2400
(505) 323-8100
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
637 RX2
NM
225100000X
Physical Therapist
1020
NM
225700000X
Massage Therapist
3556
NM
Other
Enumeration date
09/19/2008
Last updated
09/19/2008
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