Healthcare Provider Details

I. General information

NPI: 1053470187
Provider Name (Legal Business Name): HANDS ON PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 MONTGOMERY BLVD NE SUITE 302
ALBUQUERQUE NM
87111-2468
US

IV. Provider business mailing address

9201 MONTGOMERY BLVD NE SUITE 302
ALBUQUERQUE NM
87111-2468
US

V. Phone/Fax

Practice location:
  • Phone: 505-293-6262
  • Fax: 505-293-6622
Mailing address:
  • Phone: 505-293-6262
  • Fax: 505-293-6622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LINDA MCCLANAHAN
Title or Position: OWNER
Credential: P.T.
Phone: 505-293-6262