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NPI Code Detail

MEDICARE: DR. WENDY D BIRCHER PT, EDD

MEDICARE: DR. WENDY D BIRCHER PT, EDD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist348NM

General Provider Information

NPI Number : 1104033539
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WENDY D BIRCHER PT, EDD
Provider Business Mailing Address
First Line : 4002 SKYLINE DR
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-9220
Country : US
Telephone Number : 505-566-3407
Fax Number : 505-566-3767
Provider Business Practice Location Address
First Line : 608 REILLY AVE
Second Line :
City : FARMINGTON
State : NM
Zip : 87401-2634
Country : US
Telephone Number : 505-327-7720
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2007
Last Update Date : 07/08/2007

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