| NPI | 1255530044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIPE J. MARES Owner 505-884-4609 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NM 225100000x) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2019-04-05 |