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General NPI Number Information
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NPI Number | 1023760352
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Entity Type | Individual
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Provider Name | BRIANNA VICTORIA TAPIA PTA
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Gender | Female
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 2929 COORS BLVD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1173
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Country | US
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Telephone | 505-836-4899
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 VALENTINO ST NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-3596
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Country | US
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Telephone | 505-985-4440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA1189
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License Number State | NM
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