Healthcare Provider Details

I. General information

NPI: 1699753491
Provider Name (Legal Business Name): MARGARET TENNYSON-ROBEY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 TRINITY DR STE. N.
LOS ALAMOS NM
87544-4103
US

IV. Provider business mailing address

2101 TRINITY DR STE. N.
LOS ALAMOS NM
87544-4103
US

V. Phone/Fax

Practice location:
  • Phone: 505-661-6191
  • Fax: 505-663-0386
Mailing address:
  • Phone: 505-661-6191
  • Fax: 505-663-0386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number460
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number460
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number460
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number460
License Number StateNM
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number460
License Number StateNM
# 6
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number460
License Number StateNM
# 7
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number460
License Number StateNM
# 8
Primary TaxonomyN
Taxonomy Code2251H1300X
TaxonomyHuman Factors Physical Therapist
License Number460
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: