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General NPI Number Information
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NPI Number | 1881601375
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Entity Type | Organization
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Legal Business Name | LOS NINOS THERAPY CENTER
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 336 LUNA AVENUE
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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 | 505-865-7955
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Fax | 505-866-7191
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Provider Business Mailing Address
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Address Line | PO BOX 1436
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City | LOS LUNAS
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State | NM
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Zip | 87031-1436
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Country | US
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Telephone | 505-865-7955
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Fax | 505-866-7191
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Authorized Official
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Title or Position | PT/ADMINISTRATOR
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Name | MRS. TONI ANN A. MARTINEZ
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Credential | PHYSICAL THERAPIST
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Telephone | 505-865-7955
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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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