Organization
BACK TO HEALTH CLINIC LIMITED
Active
Other names
Inline Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRACY MARQUEZ (PRESIDENT)
(505) 334-5000
Entity
Organization
Contact information
Practice address
7423 TRICIA RD NE, ALBUQUERQUE, NM 87113-1797
(505) 334-5000
Mailing address
7423 TRICIA RD NE, ALBUQUERQUE, NM 87113-1797
(505) 860-1418
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1322
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM01KC73
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/23/2006
Last updated
01/03/2019
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