Healthcare Provider Details

I. General information

NPI: 1053263996
Provider Name (Legal Business Name): ROOS PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 CONSTITUTION PLACE NE
ALBUQUERQUE NM
87110
US

IV. Provider business mailing address

9701 MONTGOMERY BLVD NE # 1088
ALBUQUERQUE NM
87111-3501
US

V. Phone/Fax

Practice location:
  • Phone: 303-917-7046
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN A ROOS
Title or Position: OWNER
Credential: PT, DPT
Phone: 303-917-7046