Healthcare Provider Details

I. General information

NPI: 1871969808
Provider Name (Legal Business Name): ENDPOINT WELLNESS HOLDINGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 SAN PEDRO DR NE B2
ALBUQUERQUE NM
87110-3334
US

IV. Provider business mailing address

2730 SAN PEDRO DR NE B2
ALBUQUERQUE NM
87110-3334
US

V. Phone/Fax

Practice location:
  • Phone: 505-433-2054
  • Fax: 505-214-5659
Mailing address:
  • Phone: 505-433-2054
  • Fax: 505-214-5659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1161
License Number StateNM

VIII. Authorized Official

Name: DR. GEOFFREY N HAYES
Title or Position: PRESIDENT, DO M
Credential: DOM
Phone: 505-433-2054