Individual
DR. BRIAN T. SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1444 S SAINT FRANCIS DR, SUITE C, SANTA FE, NM 87505-4229
(505) 660-2080
(505) 983-7554
Mailing address
1444 S SAINT FRANCIS DR, SUITE C, SANTA FE, NM 87505-4229
(505) 660-2080
(505) 983-7554
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1538
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-3814567
STATE TAX ID
NM
01
—
043814567
UNITED HLTHCARE PROV ID
NM
01
—
NM00KL90
BCBS PROVIDER ID
NM
Enumeration date
12/26/2006
Last updated
09/18/2009
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