Individual provider · Type 1 NPI
Doug Pendergrass, DC
Chiropractor · Flora Vista, NM
NPI number
1902942352
Active
Practice location
12 Road 3540
Flora Vista, NM 87415-9601
Fax (505) 860-0862
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 1679 (NM) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
About NPI 1902942352
Doug Pendergrass, DC's National Provider Identifier is 1902942352, issued on Jan 30, 2007. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Flora Vista, NM. The record was last updated on Dec 30, 2015.