| NPI | 1114937695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD GENE CASAUS Director Registered Agent LLC 505-823-1230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 1242) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NM 4329) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2020-08-22 |