Organization Name: | RIO RANCHO PHYSICAL THERAPY |
NPI Number: | 1104869387 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAN HOGSTROM (ADMINISTRATOR PT) |
Mailing Address: | 4516 Arrowhead Ridge Dr Se Rio Rancho |
State: | NM US |
Postal Code: | 87124 |
Phone Number: | 5058964978 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 11/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |