| NPI | 1710349220 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CURT JASON CHAVEZ Owner 505-872-3408  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer | 
| Enumeration Date | 2016-03-23 | 
| Last Update Date | 2018-06-13 |