Organization
SHAKTI CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JIWAN KHALSA DOM (ACUPUNCTURE)
(505) 753-3369
Entity
Organization
Contact information
Practice address
510 N PASEO DE ONATE, ESPANOLA, NM 87532
(505) 753-3369
(505) 753-4006
Mailing address
510 N PASEO DE ONATE, ESPANOLA, NM 87532
(505) 753-3369
(505) 753-4006
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
04/10/2014
Last updated
04/10/2014
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