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General NPI Number Information
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NPI Number | 1346688645
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Entity Type | Organization
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Legal Business Name | ASPEN OUTPATIENT SERVICES, LLC
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Dates
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Enumeration Date | 06/07/2013
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Last Update Date | 06/12/2013
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Provider Practice Location Address
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Address Line | 2929 COORS BLVD NW STE 100
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1173
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Country | US
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Telephone | 505-239-8969
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Fax | 866-447-8129
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Provider Business Mailing Address
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Address Line | 2929 COORS BLVD NW STE 100
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1173
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Country | US
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Telephone | 505-239-8969
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Fax | 866-447-8129
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Authorized Official
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Title or Position | MEMBER
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Name | MRS. ALISA LEVANDOSKI
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Credential | PT
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Telephone | 505-239-8969
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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 | 2775
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License Number State | NM
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