Provider Demographics
NPI:1376668236
Name:BJORKLUND, ALIX PAMELA (DOM DOCTOR OF ORI)
Entity Type:Individual
Prefix:MS
First Name:ALIX
Middle Name:PAMELA
Last Name:BJORKLUND
Suffix:
Gender:F
Credentials:DOM DOCTOR OF ORI
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:JEAN
Other - Last Name:BJORKLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DOM
Mailing Address - Street 1:369 MONTEZUMA AVE.
Mailing Address - Street 2:#418
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501
Mailing Address - Country:US
Mailing Address - Phone:505-982-5156
Mailing Address - Fax:505-982-2344
Practice Address - Street 1:2019 GALISTEO ST.
Practice Address - Street 2:STE. N-4
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-982-5156
Practice Address - Fax:505-982-2344
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMNM316171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist