| NPI | 1568288744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN KOEHLER Owner 505-727-4725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2025-07-01 |