Healthcare Provider Details

I. General information

NPI: 1114932811
Provider Name (Legal Business Name): CONSTANCE GEHRING D.O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ACUPUNCTURE ETC. LLC 11000 SPAIN RD. NE, BLDG. E
ALBUQUERQUE NM
87111
US

IV. Provider business mailing address

P.O. BOX 91871
ALBUQUERQUE NM
87199
US

V. Phone/Fax

Practice location:
  • Phone: 505-264-0024
  • Fax: 505-271-6668
Mailing address:
  • Phone: 505-264-0024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number822
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: