Healthcare Provider Details

I. General information

NPI: 1467750471
Provider Name (Legal Business Name): BYBEE L WOODWARD LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BYBEE L LUDWIG LMT

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2599 SANDHILL RD
LAS CRUCES NM
88012-7403
US

IV. Provider business mailing address

2599 SANDHILL RD
LAS CRUCES NM
88012-7403
US

V. Phone/Fax

Practice location:
  • Phone: 575-644-0113
  • Fax:
Mailing address:
  • Phone: 575-644-0113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number4738
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: