Provider Demographics
NPI:1144181462
Name:THUNDERHEART HEALING, LLC
Entity type:Organization
Organization Name:THUNDERHEART HEALING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, LMT
Authorized Official - Phone:505-990-8171
Mailing Address - Street 1:HC 61 BOX 1012
Mailing Address - Street 2:
Mailing Address - City:RAMAH
Mailing Address - State:NM
Mailing Address - Zip Code:87321-9600
Mailing Address - Country:US
Mailing Address - Phone:505-990-8171
Mailing Address - Fax:
Practice Address - Street 1:801 E ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2115
Practice Address - Country:US
Practice Address - Phone:505-990-8171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-18
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty