Healthcare Provider Details

I. General information

NPI: 1871358341
Provider Name (Legal Business Name): CHI MASSAGE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2024
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 SAN PEDRO DR NE STE 119
ALBUQUERQUE NM
87110-3364
US

IV. Provider business mailing address

2727 SAN PEDRO DR NE STE 119
ALBUQUERQUE NM
87110-3364
US

V. Phone/Fax

Practice location:
  • Phone: 505-633-2756
  • Fax:
Mailing address:
  • Phone: 505-633-2756
  • 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: CATHERINE CARNELL
Title or Position: PRESIDENT
Credential: LMT
Phone: 505-506-0321