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General NPI Number Information
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NPI Number | 1205341229
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Entity Type | Organization
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Legal Business Name | ANSHIN JAPANESE ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 12/13/2017
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Provider Practice Location Address
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Address Line | 3539 THAXTON AVE SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1628
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Country | US
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Telephone | 505-750-2764
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Fax | 505-508-0872
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Provider Business Mailing Address
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Address Line | 3501 GARCIA ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-4653
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Country | US
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Telephone | 517-899-4505
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Fax |
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Authorized Official
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Title or Position | OWNER, PRACTITIONER
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Name | DR. ERIC MICHAELSEN
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Credential | DOM
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Telephone | 505-750-2764
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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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