Healthcare Provider Details

I. General information

NPI: 1144327321
Provider Name (Legal Business Name): CHINESE NATURAL THERAPY LC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5005 PROSPECT AVE NE SUITE A
ALBUQUERQUE NM
87110-4275
US

IV. Provider business mailing address

5005 PROSPECT AVE NE SUITE A
ALBUQUERQUE NM
87110-4275
US

V. Phone/Fax

Practice location:
  • Phone: 505-872-8238
  • Fax: 505-872-9378
Mailing address:
  • Phone: 505-872-8238
  • Fax: 505-872-9378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number452
License Number StateNM

VIII. Authorized Official

Name: DR. HUA C WU
Title or Position: PRESIDENT
Credential: DOM
Phone: 505-872-8238