Healthcare Provider Details

I. General information

NPI: 1396669545
Provider Name (Legal Business Name): MAXGOAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 MAN O WAR ST SE
ALBUQUERQUE NM
87123-2383
US

IV. Provider business mailing address

1809 MAN O WAR ST SE
ALBUQUERQUE NM
87123-2383
US

V. Phone/Fax

Practice location:
  • Phone: 505-803-5555
  • 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: ESTEBAN ALINDOGAN
Title or Position: PT/OWNER
Credential:
Phone: 505-803-5555