| NPI | 1841302379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MCMILLAN Administrator 575-534-1919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: NM NM98-375) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: NM NM98-375) | |
| 208100000X Physical Medicine & Rehabilitation | |
| 224Z00000X Occupational Therapy Assistant | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-05-25 |