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General NPI Number Information
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NPI Number | 1376731091
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Entity Type | Organization
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Legal Business Name | OPTIONS ACUPUNCTURE
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 9601 SIERRA VISTA CT NE SUITE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3422
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Country | US
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Telephone | 505-918-7596
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Fax |
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Provider Business Mailing Address
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Address Line | 4816 GOODRICH AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-1139
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Country | US
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Telephone | 505-918-7596
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF ORIENTAL MEDICINE
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Name | DR. BRENDA KAY PETTY
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Credential |
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Telephone | 505-918-7596
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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 | 857
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License Number State | NM
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