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General NPI Number Information
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NPI Number | 1144519752
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Entity Type | Individual
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Provider Name | NATASHA A WELLS D.O.M
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Gender | Female
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Dates
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Enumeration Date | 04/04/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 4916 4TH ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-3949
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Country | US
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Telephone | 505-328-8008
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2806
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City | CORRALES
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State | NM
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Zip | 87048-2806
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Country | US
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Telephone | 505-328-8008
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1049
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License Number State | NM
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