Provider Demographics
NPI:1508342593
Name:ACUPUNTURE LLC
Entity Type:Organization
Organization Name:ACUPUNTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHTARA
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-603-4344
Mailing Address - Street 1:2003 HOPI RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-2401
Mailing Address - Country:US
Mailing Address - Phone:505-603-4344
Mailing Address - Fax:
Practice Address - Street 1:COUNTRY ROAD BO11 #26
Practice Address - Street 2:
Practice Address - City:HOLMAN
Practice Address - State:NM
Practice Address - Zip Code:87723
Practice Address - Country:US
Practice Address - Phone:505-603-4344
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1174171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty