Luz De Vida LLC
Acupuncturist in Espanola, NM. Organization (NPI-2).
NPI number1063677516
StatusActive
Last updated in NPPESJul 24, 2008
Details
- NPI
- 1063677516
- Entity type
- Organization (NPI-2)
- Legal business name
- Luz De Vida LLC
- Organization subpart
- No
- Enumeration date
- Jul 24, 2008
- Last updated
- Jul 24, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171100000X | Acupuncturist | 240 | NM | Yes |
Other names
- Luz De Vida (Former Legal Business Name)
Practice location
705 Middle San PedroEspanola, NM 87532
Phone 505-747-7242 · Fax 505-747-7242
Mailing address
Po Box 2901Espanola, NM 87532
Phone 505-747-7242 · Fax 505-747-7241
Authorized official
Paloma Terese Blaire
Owner Physician
5057477242
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