| NPI | 1174867915 |
|---|---|
| Doing Business As | PHYSICAL THERAPY CENTER |
| Entity Type | Organization |
| Authorized Contact | LOGAN ARDEN KANODE Owner 505-454-1213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NM 4234) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NM 4234) |
| Enumeration Date | 2012-11-17 |
| Last Update Date | 2014-06-18 |