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General NPI Number Information
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NPI Number | 1073734836
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Entity Type | Individual
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Provider Name | JENNIFER LEIGH TREJO P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 1000 RIVERVIEW DR SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-0920
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Country | US
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Telephone | 505-312-9274
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Fax |
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Provider Business Mailing Address
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Address Line | 9507 TASCO DR NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2223
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Country | US
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Telephone | 505-321-8993
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3166
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License Number State | NM
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