| NPI | 1790457356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE W. ALLEN Clinical Director 505-220-7864 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-10-01 |
| Last Update Date | 2021-10-01 |