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General NPI Number Information
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NPI Number | 1770069478
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Entity Type | Individual
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Provider Name | ERIN M FUSTING DPT
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Gender | Female
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 1307 PASEO DEL PUEBLO NORTE
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City | EL PRADO
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State | NM
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Zip | 87529
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Country | US
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Telephone | 575-770-5661
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Fax | 575-221-0424
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Provider Business Mailing Address
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Address Line | 623 ACADEMY LN
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City | TAOS
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State | NM
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Zip | 87571-6416
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Country | US
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Telephone | 970-708-7031
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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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