| NPI | 1396851952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE SMITH Controller 575-396-8540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NM 6592) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2015-01-14 |