Provider Demographics
NPI:1730401225
Name:FINNEGAN, MICHAEL M (DOM, LMT, CMTPT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:M
Last Name:FINNEGAN
Suffix:
Gender:M
Credentials:DOM, LMT, CMTPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 COORS BLVD NW STE E
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-1926
Mailing Address - Country:US
Mailing Address - Phone:505-897-6560
Mailing Address - Fax:505-715-5537
Practice Address - Street 1:4103 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1102
Practice Address - Country:US
Practice Address - Phone:505-830-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-24
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5954225700000X
NM1221171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist