Healthcare Provider Details

I. General information

NPI: 1841461522
Provider Name (Legal Business Name): REHABILITATION ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 JEFFERSON STREET, NE
ALBUQUERQUE NM
87199
US

IV. Provider business mailing address

PO BOX 90700
ALBUQUERQUE NM
87199-0700
US

V. Phone/Fax

Practice location:
  • Phone: 505-344-9478
  • Fax:
Mailing address:
  • Phone: 505-994-4696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD2008-0062
License Number StateNM

VIII. Authorized Official

Name: DR. ANGELA KARA EATON-WALKER
Title or Position: OWNER
Credential: M.D.
Phone: 505-264-8972