| NPI | 1134303191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LYNNE CILLESSEN President 505-872-9882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NM 1376) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2016-08-30 |