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General NPI Number Information
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NPI Number | 1144676149
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Entity Type | Organization
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Legal Business Name | ACUHEALTH ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 511 W SAN MATEO RD
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City | SANTA FE
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State | NM
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Zip | 87505-4027
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Country | US
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Telephone | 505-983-1234
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Fax | 844-450-2837
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Provider Business Mailing Address
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Address Line | PO BOX 22187
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City | SANTA FE
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State | NM
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Zip | 87502-2187
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Country | US
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Telephone | 505-983-1234
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Fax | 844-450-2837
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Authorized Official
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Title or Position | DOCTOR
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Name | LAURA OLSON
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Credential | DOM
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Telephone | 505-983-1234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 465
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License Number State | NM
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