| NPI | 1427130137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS H FAGAN President 505-424-0131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NM 6292) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2017-06-01 |