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1558979245
TYLER VAN BASTIAN
ALBUQUERQUE, NM
NPI
1558979245
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NM PT5730)
Enumeration Date
2020-07-19
Last Update Date
2020-07-19
Business Address
TYLER VAN BASTIAN DPT
2100 LOUISIANA BLVD NE STE 410
ALBUQUERQUE, NM 87110-5412
Phone number: 505-724-4300
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Mailing Address
TYLER VAN BASTIAN DPT
5120 ALBERTA AVE NE
RIO RANCHO, NM 87144-6482
Phone number: 505-615-6368
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