| NPI | 1265498471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA C. RADOSEVICH Owner/Therapist 575-257-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 1781) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-08-29 |