Healthcare Provider Details

I. General information

NPI: 1750478384
Provider Name (Legal Business Name): SMART HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 SILVER AVE SE
ALBUQUERQUE NM
87106-1438
US

IV. Provider business mailing address

3415 SILVER AVE SE
ALBUQUERQUE NM
87106-1438
US

V. Phone/Fax

Practice location:
  • Phone: 505-265-5087
  • Fax:
Mailing address:
  • Phone: 505-265-5087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number467RX2
License Number StateNM

VIII. Authorized Official

Name: DR. SUZANNE SMART
Title or Position: PRESIDENT
Credential: DOM
Phone: 505-265-5087