Healthcare Provider Details

I. General information

NPI: 1376668236
Provider Name (Legal Business Name): ALIX PAMELA BJORKLUND D.O.M. DOCTOR OF ORI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAMELA JEAN BJORKLUND D.O.M.

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2019 GALISTEO ST. STE. N-4
SANTA FE NM
87505
US

IV. Provider business mailing address

369 MONTEZUMA AVE. #418
SANTA FE NM
87501
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-5156
  • Fax: 505-982-2344
Mailing address:
  • Phone: 505-982-5156
  • Fax: 505-982-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberNM316
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: