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General NPI Number Information
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NPI Number | 1881013969
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Entity Type | Organization
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Legal Business Name | CHOICE HEALING ARTS LLC
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 5520 WYOMING BLVD NE WELLNESS CENTER IN THE JCC, #209 & #212
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-3238
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Country | US
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Telephone | 505-604-5593
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 ESPANOLA ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3522
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Country | US
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Telephone | 505-604-5593
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. YVONNE WYLIE WALSTON
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Credential | D.O.M.
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Telephone | 505-604-5593
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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 | 1114
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License Number State | NM
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