Healthcare Provider Details

I. General information

NPI: 1790878825
Provider Name (Legal Business Name): HEALING HANDS WELLNES CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 E AZTEC AVE STE 7
GALLUP NM
87301-4946
US

IV. Provider business mailing address

PO BOX 3515
GALLUP NM
87305-3515
US

V. Phone/Fax

Practice location:
  • Phone: 505-722-3979
  • Fax: 505-722-6040
Mailing address:
  • Phone: 505-722-3979
  • Fax: 505-722-6040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1613
License Number StateNM

VIII. Authorized Official

Name: DR. LINDA R. HITE
Title or Position: OWNER, PRESIDENT
Credential: D.C.
Phone: 505-722-3979