Provider Demographics
NPI:1881013969
Name:CHOICE HEALING ARTS LLC
Entity Type:Organization
Organization Name:CHOICE HEALING ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:WYLIE
Authorized Official - Last Name:WALSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-604-5593
Mailing Address - Street 1:2817 ESPANOLA ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3522
Mailing Address - Country:US
Mailing Address - Phone:505-604-5593
Mailing Address - Fax:
Practice Address - Street 1:5520 WYOMING BLVD NE
Practice Address - Street 2:WELLNESS CENTER IN THE JCC, #209 & #212
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3238
Practice Address - Country:US
Practice Address - Phone:505-604-5593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1114171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty