Provider Demographics
NPI:1548650245
Name:APOLLO CHIROPRACTIC HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:APOLLO CHIROPRACTIC HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:DAHL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:505-792-3311
Mailing Address - Street 1:6911 TAYLOR RANCH RD NW STE C8
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2962
Mailing Address - Country:US
Mailing Address - Phone:505-792-3311
Mailing Address - Fax:505-792-3312
Practice Address - Street 1:6911 TAYLOR RANCH RD NW STE C8
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-2962
Practice Address - Country:US
Practice Address - Phone:505-792-3311
Practice Address - Fax:505-792-3312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-02
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2100111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty