Healthcare Provider Details

I. General information

NPI: 1710147574
Provider Name (Legal Business Name): DR. LI'S ACUPUNCTURE & NATURAL HERBS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7801 ACADEMY RD NE
ALBUQUERQUE NM
87109-3379
US

IV. Provider business mailing address

9630 MACALLAN RD NE
ALBUQUERQUE NM
87109-6476
US

V. Phone/Fax

Practice location:
  • Phone: 505-620-9853
  • Fax:
Mailing address:
  • Phone: 505-620-9853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number741
License Number StateNM

VIII. Authorized Official

Name: LI LI
Title or Position: DOCTOR OF ORIENTAL MEDICINE
Credential:
Phone: 505-620-9853