Provider Demographics
NPI:1245578277
Name:ACUPUNCTURE HEALING ALTERNATIVES, LLC
Entity type:Organization
Organization Name:ACUPUNCTURE HEALING ALTERNATIVES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-757-2140
Mailing Address - Street 1:BOX 1012
Mailing Address - Street 2:16 FREDS LOOP
Mailing Address - City:PEOCS
Mailing Address - State:NM
Mailing Address - Zip Code:87552-1012
Mailing Address - Country:US
Mailing Address - Phone:505-757-2140
Mailing Address - Fax:
Practice Address - Street 1:16 FREDS LOOP
Practice Address - Street 2:BOX 1012
Practice Address - City:PEOCS
Practice Address - State:NM
Practice Address - Zip Code:87552-1012
Practice Address - Country:US
Practice Address - Phone:505-757-2140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1487908729OtherNPI