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NPI Code Detail

MEDICARE: PRISCILLA HILL PTA

MEDICARE: PRISCILLA HILL PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantA-1146NM

General Provider Information

NPI Number : 1992177372
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRISCILLA HILL PTA
Provider Business Mailing Address
First Line : PO BOX 46261
Second Line :
City : RIO RANCHO
State : NM
Zip : 87174-6261
Country : US
Telephone Number : 505-417-0496
Fax Number :
Provider Business Practice Location Address
First Line : 5901 OURAY RD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-1381
Country : US
Telephone Number : 505-417-0496
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2015
Last Update Date : 10/26/2015

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