| NPI | 1902437817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMAS WEILER Contracting Manager 505-433-2755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2020-01-29 |