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General NPI Number Information
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NPI Number | 1144181462
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Entity Type | Organization
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Legal Business Name | THUNDERHEART HEALING, LLC
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Dates
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Enumeration Date | 11/18/2025
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 801 E ROOSEVELT AVE
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City | GRANTS
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State | NM
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Zip | 87020-2115
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Country | US
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Telephone | 505-990-8171
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Fax |
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Provider Business Mailing Address
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Address Line | HC 61 BOX 1012
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City | RAMAH
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State | NM
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Zip | 87321-9600
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Country | US
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Telephone | 505-990-8171
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. EDWIN GREGORY MYERS
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Credential | DOM, LMT
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Telephone | 505-990-8171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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