Healthcare Provider Details

I. General information

NPI: 1457897555
Provider Name (Legal Business Name): ACU-BALANCE & HERBS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2017
Last Update Date: 01/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7212 PEREGRINE RD NE
ALBUQUERQUE NM
87113-2904
US

IV. Provider business mailing address

PO BOX 94508
ALBUQUERQUE NM
87199-4508
US

V. Phone/Fax

Practice location:
  • Phone: 505-577-5287
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1159
License Number StateNM

VIII. Authorized Official

Name: DR. ZHONG LIU
Title or Position: DOM
Credential:
Phone: 505-577-5287