Provider Demographics
NPI:1487526513
Name:AMORE DOMENICA
Entity type:Organization
Organization Name:AMORE DOMENICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASSAGE THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HOLDERRIED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-234-6188
Mailing Address - Street 1:11723 GALLANT FOX RD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-2591
Mailing Address - Country:US
Mailing Address - Phone:505-234-6188
Mailing Address - Fax:
Practice Address - Street 1:1020 SAN PEDRO DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-6722
Practice Address - Country:US
Practice Address - Phone:505-234-6188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty