Provider Demographics
NPI:1427079433
Name:BACK IN MOTION CHIROPRACTIC LLC
Entity type:Organization
Organization Name:BACK IN MOTION CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-396-5431
Mailing Address - Street 1:PO BOX 1514
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:88260-1514
Mailing Address - Country:US
Mailing Address - Phone:575-739-2225
Mailing Address - Fax:575-739-2225
Practice Address - Street 1:201 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LOVINGTON
Practice Address - State:NM
Practice Address - Zip Code:88260-4020
Practice Address - Country:US
Practice Address - Phone:575-739-2225
Practice Address - Fax:575-739-2225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1658261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1235168147OtherDR MURRISH NPI
NM1658OtherCHIROPRACTIC LICENSE
TX9244OtherDR. MURRISH TX LICENSE NR
1235168147OtherDR MURRISH NPI
TX9244OtherDR. MURRISH TX LICENSE NR