| NPI | 1285267849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK HALLADAY Owner 575-430-8648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2023-01-17 |