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General NPI Number Information
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NPI Number | 1205253812
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Entity Type | Organization
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Legal Business Name | DAN C. TRIGG MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 03/20/2014
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Provider Practice Location Address
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Address Line | 305 E MIEL DE LUNA AVE
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City | TUCUMCARI
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State | NM
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Zip | 88401-3810
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Country | US
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Telephone | 575-461-7230
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Fax | 575-461-7231
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Provider Business Mailing Address
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Address Line | 305 E MIEL DE LUNA AVE
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City | TUCUMCARI
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State | NM
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Zip | 88401-3810
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | AUDREY HEMMINGER
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Credential | PT, DPT
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Telephone | 575-461-7230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 4435
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License Number State | NM
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