Organization
KOKOPELLI EAST WEST INTEGRATED FAMILY WALK-IN CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DK PARK DOM (OFFICE MANAGER)
(505) 514-2900
Entity
Organization
Contact information
Practice address
6501 EAGLE ROCK AVE NE, BUDG A6, ALBUQUERQUE, NM 87113-2479
(505) 514-2900
(505) 797-5400
Mailing address
6501 EAGLE ROCK AVE NE, BUDG A6, ALBUQUERQUE, NM 87113-2479
(505) 514-2900
(505) 797-2905
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
866RX-1
NM
225100000X
Physical Therapist
Primary
2074
NM
Other
Enumeration date
11/17/2006
Last updated
03/28/2012
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