Healthcare Provider Details
I. General information
NPI: 1689830705
Provider Name (Legal Business Name): CHINESE ACUPUNCTURE INSTITUTE OF NEW MEXICO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/29/2008
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 PENNSYLVANIA CIR NE SUITE A
ALBUQUERQUE NM
87110-7827
US
IV. Provider business mailing address
7900 PENNSYLVANIA CIR NE SUITE A
ALBUQUERQUE NM
87110-7827
US
V. Phone/Fax
- Phone: 505-265-5168
- Fax: 505-265-5168
- Phone: 505-265-5168
- Fax: 505-265-5168
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 419/417 |
| License Number State | NM |
VIII. Authorized Official
Name: DR.
WEI
ZHOU
Title or Position: DOCTOR OF ORIENTAL MEDICINE/OWNER
Credential: DOM
Phone: 505-265-5168