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General NPI Number Information
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NPI Number | 1396474466
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Entity Type | Individual
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Provider Name | STEPHEN COLE PT
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Gender | Male
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Dates
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Enumeration Date | 06/06/2022
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 8325 2ND ST NW
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City | LOS RANCHOS DE ALBUQUERQUE
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State | NM
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Zip | 87114-1013
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Country | US
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Telephone | 505-266-3655
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Fax |
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Provider Business Mailing Address
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Address Line | 8325 2ND ST NW
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City | LOS RANCHOS DE ALBUQUERQUE
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State | NM
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Zip | 87114-1013
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Country | US
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Telephone | 631-894-7080
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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 |
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License Number State |
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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 | J1-0014553
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT-2024-0202
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License Number State | NM
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