| NPI | 1467704957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PARK Business Manager 505-514-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 2074) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NM 866RX1) |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |