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General NPI Number Information
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NPI Number | 1144464579
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Entity Type | Individual
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Provider Name | GLORGILINE PASCO LOMARQUEZ PT
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Gender | Female
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | 2425 RIDGECREST DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108
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Country | US
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Telephone | 505-348-9630
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Fax | 505-348-4976
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Provider Business Mailing Address
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Address Line | 2425 RIDGECREST DR SE
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City | ALBUQUERQUE
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State | NM
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Zip | 87108-5129
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Country | US
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Telephone | 410-750-9006
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Fax | 410-750-0787
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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 | PT0400003788
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License Number State | VT
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