Provider Demographics
NPI: | 1851520308 |
---|---|
Name: | CHELY'S NATURAL THERAPEUTICS |
Entity type: | Organization |
Organization Name: | CHELY'S NATURAL THERAPEUTICS |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | MICHEL |
Authorized Official - Middle Name: | CHELY |
Authorized Official - Last Name: | CARTAGENA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 505-280-6737 |
Mailing Address - Street 1: | 10328 PINTURA PL NW |
Mailing Address - Street 2: | |
Mailing Address - City: | ALBUQUERQUE |
Mailing Address - State: | NM |
Mailing Address - Zip Code: | 87114-4178 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 505-280-6737 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 10328 PINTURA PL NW |
Practice Address - Street 2: | |
Practice Address - City: | ALBUQUERQUE |
Practice Address - State: | NM |
Practice Address - Zip Code: | 87114-4178 |
Practice Address - Country: | US |
Practice Address - Phone: | 505-280-6737 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2009-07-06 |
Last Update Date: | 2009-07-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NM | LMT 6084 | 173C00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 173C00000X | Other Service Providers | Reflexologist | Group - Single Specialty |