Healthcare Provider Details

I. General information

NPI: 1851713663
Provider Name (Legal Business Name): ARMADA PHYSICAL THERAPY OF ALBUQUERQUE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2014
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 COORS BLVD NW STE 100
ALBUQUERQUE NM
87120-1173
US

IV. Provider business mailing address

2600 DALLAS PKWY STE 290
FRISCO TX
75034-7493
US

V. Phone/Fax

Practice location:
  • Phone: 505-836-4990
  • Fax: 505-908-3918
Mailing address:
  • Phone: 945-260-0010
  • Fax: 760-268-1301

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: ROBERT PACE
Title or Position: CONTRACTING
Credential:
Phone: 945-260-0010