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General NPI Number Information
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NPI Number | 1871230326
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Entity Type | Individual
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Provider Name | JESSICA CHRISTINE CORTEZ MORALES PT
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Gender | Female
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Dates
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Enumeration Date | 05/17/2022
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | PINON HEALTH CENTER NAVAJO SERVICE RTE 41
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City | PINON
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State | AZ
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Zip | 86510
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Country | US
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Telephone | 928-725-9631
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Fax |
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Provider Business Mailing Address
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Address Line | 6916 WALNUT CREEK RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2834
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Country | US
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Telephone | 765-702-5504
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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 | PT5218
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License Number State | NM
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