| NPI | 1760958730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC DOUGLAS PAYNE Owner 505-257-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251X0800X Physical Therapist, Orthopedic |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |