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General NPI Number Information
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NPI Number | 1326371279
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Entity Type | Organization
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Legal Business Name | MOTHER OF MERCY ACUPUNCTURE&HERBAL CLINIC
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 09/10/2009
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Provider Practice Location Address
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Address Line | 301 WASHINGTON SE MOTHER OF MERCY ACUPUNCTURE & HERB CLINIC
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-2734
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Country | US
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Telephone | 150-524-4840
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Fax | 150-524-3147
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Provider Business Mailing Address
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Address Line | 6017 HANNETTE NE DIANE M. HURSH DOM
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City | ALBUQUERQUE , 87110
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State | NM
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Zip | 87110-5914
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Country | US
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Telephone | 150-524-4841
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Fax | 150-524-3155
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Authorized Official
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Title or Position | PRESIDENT- OF NON-PROFIT
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Name | DR. MARGARET DIANE HURSH
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Credential | DOM
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Telephone | 15052448401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 57-1172394
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License Number State | NM
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