Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 1057 | NM |
N | 363LF0000X | Nurse Practitioner - Family Medicine | CNP-02134 | NM |
NPI | 1831101021 |
---|---|
Provider Name | Dr. Christopher C. Cecil |
First Address | Albuquerque, NM 87102-1716 |
Second Address | Albuquerque, NM 87102-1716 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/04/2015 |