Healthcare Provider Details

I. General information

NPI: 1023295607
Provider Name (Legal Business Name): MARY K SPINDLER PHD, DOM, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2008
Last Update Date: 01/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

914 BACA ST SUITE C
SANTA FE NM
87505-0972
US

IV. Provider business mailing address

914 BACA ST SUITE C
SANTA FE NM
87505-0972
US

V. Phone/Fax

Practice location:
  • Phone: 505-690-8855
  • Fax: 505-425-6040
Mailing address:
  • Phone: 505-690-8855
  • Fax: 505-425-6040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number661
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: