Healthcare Provider Details

I. General information

NPI: 1831521574
Provider Name (Legal Business Name): POSITIVE HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 SEQUOIA RD NW SUITE 206
ALBUQUERQUE NM
87120-1284
US

IV. Provider business mailing address

5300 SEQUOIA RD NW SUITE 206
ALBUQUERQUE NM
87120-1284
US

V. Phone/Fax

Practice location:
  • Phone: 505-550-8148
  • Fax: 505-255-7201
Mailing address:
  • Phone: 505-550-8148
  • Fax: 505-255-7201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number908
License Number StateNM

VIII. Authorized Official

Name: MS. CAROL MCGLAUCHLIN
Title or Position: OWNER
Credential: DOM
Phone: 505-550-8148