Healthcare Provider Details

I. General information

NPI: 1841476991
Provider Name (Legal Business Name): ACUPUNCTURE MEDICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 SHEFFIELD DR STE. F
CLOVIS NM
88101-4946
US

IV. Provider business mailing address

PO BOX 2947
HOBBS NM
88241-2947
US

V. Phone/Fax

Practice location:
  • Phone: 505-769-1929
  • Fax:
Mailing address:
  • Phone: 505-392-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number693
License Number StateNM

VIII. Authorized Official

Name: MRS. LEESA M LEE
Title or Position: OFFICE MANAGER
Credential:
Phone: 505-392-2712