Provider Demographics
NPI:1417780941
Name:ENSYNC HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:ENSYNC HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:ROSS
Authorized Official - Last Name:DURLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-312-5765
Mailing Address - Street 1:2101 GOLF COURSE RD SE STE C
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1760
Mailing Address - Country:US
Mailing Address - Phone:505-312-5765
Mailing Address - Fax:888-981-4950
Practice Address - Street 1:2101 GOLF COURSE RD SE STE C
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1760
Practice Address - Country:US
Practice Address - Phone:505-312-5765
Practice Address - Fax:888-981-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty