Healthcare Provider Details
I. General information
NPI: 1740692755
Provider Name (Legal Business Name): SMOOTH QI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/24/2014
Last Update Date: 09/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6739 ACADEMY RD NE SUITE 254
ALBUQUERQUE NM
87109-3351
US
IV. Provider business mailing address
6739 ACADEMY RD NE SUITE 254
ALBUQUERQUE NM
87109-3351
US
V. Phone/Fax
- Phone: 505-440-8250
- Fax: 801-655-7382
- Phone: 505-440-8250
- Fax: 801-655-7382
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 1096 |
| License Number State | NM |
VIII. Authorized Official
Name: DR.
EMILY
FERREIRA
Title or Position: DOCTOR OF ORIENTAL MEDICINE/CEO
Credential: DOM
Phone: 505-440-8250