Healthcare Provider Details

I. General information

NPI: 1225897887
Provider Name (Legal Business Name): ACUPUNCTURE CARE ABQ, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 MONTANO RD NW STE 6
LOS RANCHOS NM
87107-3245
US

IV. Provider business mailing address

1776 MONTANO RD NW STE 6
LOS RANCHOS NM
87107-3245
US

V. Phone/Fax

Practice location:
  • Phone: 505-518-2278
  • Fax: 505-295-5746
Mailing address:
  • Phone: 505-518-2278
  • Fax: 505-295-5746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: KATHY LEE
Title or Position: OWNER/PROVIDER
Credential:
Phone: 505-250-5369