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General NPI Number Information
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NPI Number | 1245380039
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Entity Type | Organization
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Legal Business Name | PARADIGM PHYSICAL THERAPY AND WELLNESS INC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 240 S. CAMINO DEL PUEBLO, SUITE G
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City | BERNALILLO
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State | NM
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Zip | 87004-5925
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Country | US
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Telephone | 505-771-2447
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Fax | 505-771-2360
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Provider Business Mailing Address
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Address Line | 535 US HIGHWAY 314
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City | LOS LUNAS
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State | NM
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Zip | 87031-9600
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Country | US
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Telephone | 505-866-0055
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Fax | 505-866-0057
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | MR. DONALD J. SANCHEZ
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Credential | P.T.
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Telephone | 505-866-0055
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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 | 2646
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License Number State | NM
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