Healthcare Provider Details

I. General information

NPI: 1285700575
Provider Name (Legal Business Name): MARGARET NOEL HEISER DOM, LMT, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6208 MONTGOMERY BLVD NE STE F
ALBUQUERQUE NM
87109-1400
US

IV. Provider business mailing address

912 WASHINGTON ST NE
ALBUQUERQUE NM
87110-6252
US

V. Phone/Fax

Practice location:
  • Phone: 505-261-0406
  • Fax:
Mailing address:
  • Phone: 505-261-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number142
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number571
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: