| NPI | 1174567366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE LORIECIE SIPPLE Physical Therapist 505-344-4959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2020-08-22 |