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General NPI Number Information
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NPI Number | 1285806406
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Entity Type | Organization
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Legal Business Name | MCFALL PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 932 GALLINAS ST SUITE 103
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City | LAS VEGAS
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State | NM
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Zip | 87701-3891
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Country | US
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Telephone | 505-425-7762
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Fax | 505-454-0801
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Provider Business Mailing Address
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Address Line | 2810 HOT SPRINGS BLVD STE A
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City | LAS VEGAS
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State | NM
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Zip | 87701-4119
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Country | US
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Telephone | 505-425-7762
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Fax | 505-454-0801
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL LEN MCFALL
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Credential | RPT
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Telephone | 505-425-7762
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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 | 1132
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License Number State | NM
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