Healthcare Provider Details

I. General information

NPI: 1871688184
Provider Name (Legal Business Name): DEL VALLE PHYSICAL THERAPY AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2445 MISSOURI AVE SUITE A
LAS CRUCES NM
88001-5111
US

IV. Provider business mailing address

2445 MISSOURI AVE SUITE A
LAS CRUCES NM
88001-5111
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-8080
  • Fax: 575-523-8861
Mailing address:
  • Phone: 505-523-8080
  • Fax: 505-523-8861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK A FIGUEROA
Title or Position: OWNER
Credential: PT
Phone: 575-523-8080