Healthcare Provider Details

I. General information

NPI: 1114842036
Provider Name (Legal Business Name): ARLENE PONCE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2205 S MAIN ST STE A
LAS CRUCES NM
88005-3113
US

IV. Provider business mailing address

2205 S MAIN ST STE A
LAS CRUCES NM
88005-3113
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-8440
  • Fax: 575-556-8439
Mailing address:
  • Phone: 575-556-8440
  • Fax: 575-556-8439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-2026-0200
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: