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General NPI Number Information
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NPI Number | 1386651412
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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 | 08/02/2006
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Last Update Date | 11/26/2013
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Provider Practice Location Address
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Address Line | 535 US HIGHWAY 314, SW
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City | LOS LUNAS
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State | NM
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Zip | 87031
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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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Provider Business Mailing Address
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Address Line | 535 HIGHWAY 314 SW
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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 | PRESIDENT/OWNER
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Name | MR. DONALD JOSEPH SANCHEZ
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Credential | PHYSICAL THERAPIST
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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 | 593
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License Number State | NM
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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 | 593
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License Number State | NM
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