| Organization Name: | SOUTHWEST SPORT AND SPINE CENTER INC |
| NPI Number: | 1164475208 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURIE DENISE CAMPBELL (DIRECTOR) |
| Mailing Address: | 2404 S Locust St Ste 5 Las Cruces |
| State: | NM US |
| Postal Code: | 880015789 |
| Phone Number: | 5055214188 |
| Fax Number: | 5055213668 |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 05/08/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |