Healthcare Provider Details

I. General information

NPI: 1700293537
Provider Name (Legal Business Name): AMERICA'S MASSAGE & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2014
Last Update Date: 07/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 SAN MATEO BLVD NE STE F
ALBUQUERQUE NM
87110-3165
US

IV. Provider business mailing address

2620 SAN MATEO BLVD NE STE F
ALBUQUERQUE NM
87110-3165
US

V. Phone/Fax

Practice location:
  • Phone: 505-888-4044
  • Fax: 505-888-1932
Mailing address:
  • Phone: 505-888-4044
  • Fax: 505-888-1932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberLMT 6928
License Number StateNM

VIII. Authorized Official

Name: DAVID PAPER
Title or Position: OWNER/MANAGER
Credential:
Phone: 505-888-4044