Healthcare Provider Details

I. General information

NPI: 1669659488
Provider Name (Legal Business Name): N-RICH PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 WISCONSIN ST NE
ALBUQUERQUE NM
87110-4849
US

IV. Provider business mailing address

1909 WISCONSIN ST NE
ALBUQUERQUE NM
87110-4849
US

V. Phone/Fax

Practice location:
  • Phone: 505-306-0530
  • Fax:
Mailing address:
  • Phone: 505-306-0530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number290
License Number StateNM

VIII. Authorized Official

Name: MS. NANCY JEAN RICH
Title or Position: OWNER
Credential: PHYSICAL THERAPIST
Phone: 505-306-0530