Healthcare Provider Details
I. General information
NPI: 1538865043
Provider Name (Legal Business Name): METHOD PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2023
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3538 ANDERSON AVE SE
ALBUQUERQUE NM
87106-1612
US
IV. Provider business mailing address
410 TULANE DR SE
ALBUQUERQUE NM
87106-1418
US
V. Phone/Fax
- Phone: 505-615-9381
- Fax: 505-431-3170
- Phone: 505-615-9381
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NORA
JACKELINE
QUINTAL CALVA
Title or Position: PHYSICAL THERAPIST AND CO-OWNER
Credential: PT, DPT
Phone: 505-250-8401