Provider Demographics
NPI:1609506062
Name:THE BACKBONE - NAPRAPATHIC REHAB CLINIC, LLC
Entity type:Organization
Organization Name:THE BACKBONE - NAPRAPATHIC REHAB CLINIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, NAPRAPATH
Authorized Official - Prefix:DR
Authorized Official - First Name:ROZEE
Authorized Official - Middle Name:G
Authorized Official - Last Name:BENAVIDES
Authorized Official - Suffix:
Authorized Official - Credentials:DN
Authorized Official - Phone:505-591-6277
Mailing Address - Street 1:4015 CARLISLE BLVD NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-4529
Mailing Address - Country:US
Mailing Address - Phone:505-591-6277
Mailing Address - Fax:
Practice Address - Street 1:4015 CARLISLE BLVD NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-4529
Practice Address - Country:US
Practice Address - Phone:505-591-6277
Practice Address - Fax:505-508-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172P00000XOther Service ProvidersNaprapathGroup - Single Specialty