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NPI 1245215326

NPI 1245215326 : BECKY AZAMA PT : KIRTLAND AFB, NM

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General NPI Number Information
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    NPI Number           |    1245215326
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    Entity Type          |    Individual 
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    Provider Name        |    BECKY AZAMA PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/12/2005
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    Last Update Date     |    07/30/2025
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Provider Practice Location Address
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    Address Line         |    2050A 2ND ST SE 
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    City                 |    KIRTLAND AFB
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    State                |    NM
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    Zip                  |    87117-5901
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    Country              |    US
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    Telephone            |    228-376-4660
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2050A 2ND ST SE 
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    City                 |    KIRTLAND AFB
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    State                |    NM
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    Zip                  |    87117-5901
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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    |    
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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       |    32052
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    License Number State |    CA
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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       |    PT32052
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    License Number State |    CA
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