Healthcare Provider Details

I. General information

NPI: 1043225493
Provider Name (Legal Business Name): ALAMOGORDO PHYSICAL THERAPY & WELLNESS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 INDIAN WELLS
ALAMOGORDO NM
88310-5012
US

IV. Provider business mailing address

PO BOX 2860
ALAMOGORDO NM
88311-2860
US

V. Phone/Fax

Practice location:
  • Phone: 575-439-1397
  • Fax: 575-437-2622
Mailing address:
  • Phone: 575-439-1397
  • Fax: 575-437-2622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3137
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3137
License Number StateNM

VIII. Authorized Official

Name: MRS. MELYNN L PATTILLO
Title or Position: BUSINESS MANAGER
Credential:
Phone: 575-439-1397