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General NPI Number Information
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NPI Number | 1023076197
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY PLUS INC
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Dates
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Enumeration Date | 05/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1350 CENTRAL AVE STE 105
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City | LOS ALAMOS
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State | NM
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Zip | 87544
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Country | US
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Telephone | 505-662-3384
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Fax | 505-661-0085
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Provider Business Mailing Address
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Address Line | 1350 CENTRAL AVE STE 105
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City | LOS ALAMOS
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State | NM
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Zip | 87544
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Country | US
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Telephone | 505-662-3384
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Fax | 505-661-0085
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNETTE WEYRAUCH
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Credential | MSPT
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Telephone | 505-662-3384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 833
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License Number State | NM
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