MEDICARE: FOUR WINDS ACUPUNCTURE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	926	NM

General Provider Information

NPI Number	:	1851588685
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOUR WINDS ACUPUNCTURE

Provider Business Mailing Address
First Line	:	1660 OLD PECOS TRL
Second Line	:	SUITE H
City	:	SANTA FE
State	:	NM
Zip	:	87505-4779
Country	:	US
Telephone Number	:	505-470-5705
Fax Number	:

Provider Business Practice Location Address
First Line	:	1660 OLD PECOS TRL
Second Line	:	SUITE H
City	:	SANTA FE
State	:	NM
Zip	:	87505-4779
Country	:	US
Telephone Number	:	505-470-5705
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR ORIENTAL MEDICINE/OWNER
Name	:	DR. NATHAN WALES
Credential	:	DOM
Telephone Number	:	505-470-5705

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	09/25/2007

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Directions to “FOUR WINDS ACUPUNCTURE ” Practice Location

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