Healthcare Provider Details

I. General information

NPI: 1740589613
Provider Name (Legal Business Name): JANE RAEL ACUPUNCTURE LA CURANDERA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 E REINKEN AVE
BELEN NM
87002-4531
US

IV. Provider business mailing address

1512 RIO GRANDE BLVD SW
LOS LUNAS NM
87031-6130
US

V. Phone/Fax

Practice location:
  • Phone: 505-565-4325
  • Fax:
Mailing address:
  • Phone: 505-565-4325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number603
License Number StateNM

VIII. Authorized Official

Name: DR. MARY JANE RAEL
Title or Position: SOLE PROPRIETOR
Credential: D.O.M.
Phone: 505-565-4325