Healthcare Provider Details

I. General information

NPI: 1306778188
Provider Name (Legal Business Name): WALK-OFF PERFORMANCE AND REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4101 PASEO DEL NORTE NE
ALBUQUERQUE NM
87113-2620
US

IV. Provider business mailing address

2112 SOLARA LOOP NE
RIO RANCHO NM
87144-5840
US

V. Phone/Fax

Practice location:
  • Phone: 505-979-1196
  • Fax:
Mailing address:
  • Phone: 505-979-1196
  • 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: NICHOLAS ROMERO
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 505-979-1196