Healthcare Provider Details

I. General information

NPI: 1801630793
Provider Name (Legal Business Name): LAURA M HINTERMEIER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 06/24/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 MISSOURI AVE STE 37
LAS CRUCES NM
88011-9151
US

IV. Provider business mailing address

324 SALOPEK BLVD
LAS CRUCES NM
88001-7600
US

V. Phone/Fax

Practice location:
  • Phone: 575-221-9623
  • Fax:
Mailing address:
  • Phone: 716-939-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5664
License Number StateNM

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: