Organization
LUZ DE VIDA LLC
Active
Other names
Luz de Vida
Organization subpart
No
Provider details
NPI number
Authorized official
PALOMA TERESE BLAIRE DO M (OWNER PHYSICIAN)
(505) 747-7242
Entity
Organization
Contact information
Practice address
705 MIDDLE SAN PEDRO, ESPANOLA, NM 87532
(505) 747-7242
(505) 747-7242
Mailing address
PO BOX 2901, ESPANOLA, NM 87532
(505) 747-7242
(505) 747-7241
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
240
NM
Other
Enumeration date
07/24/2008
Last updated
07/24/2008
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