Organization
ENHANCED WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN C. JAY DOM (OWNER)
(505) 323-8100
Entity
Organization
Contact information
Practice address
5200 EUBANK BLVD NE, SUITE C3, ALBUQUERQUE, NM 87111
(505) 323-8100
(505) 292-0555
Mailing address
5200 EUBANK BLVD NE, SUITE C3, ALBUQUERQUE, NM 87111
(505) 323-8100
(505) 292-0555
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
90-216
NM
174H00000X
Health Educator
637RX2
NM
208VP0000X
Pain Medicine Physician
90-216
NM
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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