| NPI | 1417319781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKI MARIE MCDANIEL Lead PT 505-699-5190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OR 5138) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2016-03-24 |