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1215940994
CAROLYN W FAGAN
SANTA FE, NM
NPI
1215940994
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QP2000X Clinic/Center, Physical Therapy
(Licence: NM #456)
Enumeration Date
2006-08-14
Last Update Date
2007-07-08
Business Address
-- CAROLYN W FAGAN
2954 RODEO PARK DR W
SANTA FE, NM 87505-6351
Phone number: 505-424-0131
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Mailing Address
-- CAROLYN W FAGAN
8 CLEMATIS CIR
SANTA FE, NM 87506-1292
Phone number: 505-424-0131
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