Provider Demographics
NPI:1659369064
Name:HUNT, ERICA LAI
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LAI
Last Name:HUNT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 EASTGATE DRIVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544
Mailing Address - Country:US
Mailing Address - Phone:505-662-1419
Mailing Address - Fax:505-661-0055
Practice Address - Street 1:127 EASTGATE DRIVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544
Practice Address - Country:US
Practice Address - Phone:505-662-1419
Practice Address - Fax:505-661-0055
Is Sole Proprietor?:No
Enumeration Date:2005-10-10
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM784171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist