Healthcare Provider Details

I. General information

NPI: 1730010398
Provider Name (Legal Business Name): LIFETOUCH PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6546 JACAL CT NW
ALBUQUERQUE NM
87114-6120
US

IV. Provider business mailing address

3705 ELLISON DR NW STE B1 PMB 487
ALBUQUERQUE NM
87114-7015
US

V. Phone/Fax

Practice location:
  • Phone: 505-750-0591
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHARLES BYRNES
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 505-750-0591