Provider Demographics
NPI:1740589613
Name:JANE RAEL ACUPUNCTURE LA CURANDERA
Entity type:Organization
Organization Name:JANE RAEL ACUPUNCTURE LA CURANDERA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:RAEL
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-565-4325
Mailing Address - Street 1:1512 RIO GRANDE BLVD SW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-6130
Mailing Address - Country:US
Mailing Address - Phone:505-565-4325
Mailing Address - Fax:
Practice Address - Street 1:517 E REINKEN AVE
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-4531
Practice Address - Country:US
Practice Address - Phone:505-565-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM603171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty