Healthcare Provider Details

I. General information

NPI: 1871425041
Provider Name (Legal Business Name): DANIEL CRAIG ANSBACH PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 N SONOMA RANCH BLVD STE B
LAS CRUCES NM
88011-7343
US

IV. Provider business mailing address

2746 CHEYENNE DR
LAS CRUCES NM
88011-9096
US

V. Phone/Fax

Practice location:
  • Phone: 575-222-0188
  • Fax: 575-652-4142
Mailing address:
  • Phone: 575-222-0188
  • Fax: 575-652-4142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-2026-0133
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: