Provider Demographics
NPI:1144676149
Name:ACUHEALTH ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:ACUHEALTH ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-983-1234
Mailing Address - Street 1:PO BOX 22187
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502-2187
Mailing Address - Country:US
Mailing Address - Phone:505-983-1234
Mailing Address - Fax:844-450-2837
Practice Address - Street 1:511 W SAN MATEO RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4027
Practice Address - Country:US
Practice Address - Phone:505-983-1234
Practice Address - Fax:844-450-2837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-09
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM465261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service