Healthcare Provider Details
I. General information
NPI: 1730287962
Provider Name (Legal Business Name): ACUPUNCTURE ASSOCIATES OF AMERICA, INC.
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
2901 JUAN TABO BLVD NE STE 117
ALBUQUERQUE NM
87112-1885
US
IV. Provider business mailing address
2901 JUAN TABO BLVD NE STE 117
ALBUQUERQUE NM
87112-1885
US
V. Phone/Fax
- Phone: 505-275-9602
- Fax: 505-275-9604
- Phone: 505-275-9602
- Fax: 505-275-9604
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 722RX1 |
| License Number State | NM |
VIII. Authorized Official
Name: MRS.
LORELLA
D.
TAPIA-REYES
Title or Position: OWNER
Credential: D.O.M.
Phone: 505-275-9602