| Doctor Name: | JOVITA R TIESO |
| NPI Number: | 1154513224 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P. T. |
| License Number: | 1334 |
| Business Practice Address: | 5460 Inspiration Ln Las Cruces, NM - 880116946 |
| Business Phone Number: | 5053828939 |
| Business Fax Number: | |
| Mailing Address: | 5460 Inspiration Ln, LAS CRUCES |
| State: | NM |
| Postal Code: | 880116946 |
| Phone Number: | 5053828939 |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2007 |
| NPI Last Update Date: | 08/13/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 1334 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |