Healthcare Provider Details

I. General information

NPI: 1760629661
Provider Name (Legal Business Name): CROOKED CRANE HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 4TH ST NW SUITE E
ALBUQUERQUE NM
87107-5800
US

IV. Provider business mailing address

6501 4TH ST NW SUITE E
ALBUQUERQUE NM
87107-5800
US

V. Phone/Fax

Practice location:
  • Phone: 505-250-7173
  • Fax: 505-842-0885
Mailing address:
  • Phone: 505-250-7173
  • Fax: 505-842-0885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MS. DEBORAH ANN WOZNIAK
Title or Position: DOCTOR OF ORIENTAL MEDICINE
Credential: D.O.M.
Phone: 505-250-7173