Organization
GRD HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JIWAN KHALSA DOM RX2 (DOMRX2)
(505) 753-3369
Entity
Organization
Contact information
Practice address
510 N PASEO DE ONATE, ESPANOLA, NM 87532-2618
(505) 753-3369
(505) 753-4006
Mailing address
510 N PASEO DE ONATE, ESPANOLA, NM 87532-2618
(505) 753-3369
(505) 753-4006
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
444
NM
Other
Enumeration date
07/06/2011
Last updated
07/06/2011
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