| Organization Name: | INTEGRATIVE MEDICAL CENTER OF NEW MEXICO,PC |
| NPI Number: | 1346319076 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANN BERKSON (OFFICE MANAGER) |
| Mailing Address: | 1155 Commerce Dr Ste C Las Cruces |
| State: | NM US |
| Postal Code: | 880118257 |
| Phone Number: | 5755243720 |
| Fax Number: | 5755243721 |
| NPI Enumeration Date: | 11/07/2006 |
| NPI Last Update Date: | 02/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 79-9 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |