Healthcare Provider Details

I. General information

NPI: 1487526513
Provider Name (Legal Business Name): AMORE DOMENICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2025
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 SAN PEDRO DR NE
ALBUQUERQUE NM
87110-6722
US

IV. Provider business mailing address

11723 GALLANT FOX RD SE
ALBUQUERQUE NM
87123-2591
US

V. Phone/Fax

Practice location:
  • Phone: 505-234-6188
  • Fax:
Mailing address:
  • Phone: 505-234-6188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD ANDREW HOLDERRIED
Title or Position: OWNER/MASSAGE THERAPIST
Credential:
Phone: 505-234-6188