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General NPI Number Information
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NPI Number | 1871917740
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Entity Type | Organization
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Legal Business Name | APEXNETWORK NEW MEXICO,LLC
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Dates
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Enumeration Date | 02/12/2014
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 510 W MALONEY AVE
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City | GALLUP
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State | NM
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Zip | 87301-5307
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Country | US
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Telephone | 618-651-0444
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Fax |
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Provider Business Mailing Address
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Address Line | 15 APEX DR
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City | HIGHLAND
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State | IL
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Zip | 62249-1282
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Country | US
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Telephone | 618-651-0444
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | STEVEN ORAVEC
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Credential |
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Telephone | 618-651-0444
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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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