Provider Demographics
NPI:1992950927
Name:WHOLE HEALTH CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:WHOLE HEALTH CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.C. - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:YVONNE
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:575-521-9265
Mailing Address - Street 1:755 SOUTH TELSHOR BLVD
Mailing Address - Street 2:102F
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011
Mailing Address - Country:US
Mailing Address - Phone:575-521-9265
Mailing Address - Fax:575-521-1196
Practice Address - Street 1:755 SOUTH TELSHOR BLVD
Practice Address - Street 2:102F
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011
Practice Address - Country:US
Practice Address - Phone:575-521-9265
Practice Address - Fax:575-521-1196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMN.M.1251111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00KC19OtherBCBS OF N.M.
U57182Medicare UPIN