Provider Demographics
NPI:1174718332
Name:BODYMINDSPIRIT
Entity type:Organization
Organization Name:BODYMINDSPIRIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAJOIE
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:505-281-8446
Mailing Address - Street 1:12165 HWY 14 N
Mailing Address - Street 2:SUITE B-7
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-9461
Mailing Address - Country:US
Mailing Address - Phone:505-281-8446
Mailing Address - Fax:505-281-3099
Practice Address - Street 1:12165 HWY 14 N
Practice Address - Street 2:SUITE B-7
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008-9461
Practice Address - Country:US
Practice Address - Phone:505-281-8446
Practice Address - Fax:505-281-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM640171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty