| NPI | 1114222924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA ANN PREROVSKY Physical Therapist 505-577-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NM 2683) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-01-26 |