Healthcare Provider Details

I. General information

NPI: 1881013969
Provider Name (Legal Business Name): CHOICE HEALING ARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5520 WYOMING BLVD NE WELLNESS CENTER IN THE JCC, #209 & #212
ALBUQUERQUE NM
87109-3238
US

IV. Provider business mailing address

2817 ESPANOLA ST NE
ALBUQUERQUE NM
87110-3522
US

V. Phone/Fax

Practice location:
  • Phone: 505-604-5593
  • Fax:
Mailing address:
  • Phone: 505-604-5593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1114
License Number StateNM

VIII. Authorized Official

Name: DR. YVONNE WYLIE WALSTON
Title or Position: OWNER
Credential: D.O.M.
Phone: 505-604-5593