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General NPI Number Information
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NPI Number | 1538567045
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Entity Type | Organization
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Legal Business Name | ABQ ZEN ZONE
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 8201 GOLF COURSE RD NW SUITE C2A
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-5842
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Country | US
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Telephone | 505-908-6932
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 REYNOSA LOOP SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-8740
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR OF ORIENTAL MEDICINE
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Name | DONNA G ALIPAT
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Credential | D.O.M
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Telephone | 505-908-6932
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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 | 1146
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License Number State | NM
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