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NPI Code Detail

MEDICARE: PHILIP TOUPS PTA

MEDICARE: PHILIP TOUPS PTA
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
1225200000XPhysical Therapy AssistantA-0954NM

General Provider Information

NPI Number : 1356739981
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILIP TOUPS PTA
Provider Business Mailing Address
First Line : PO BOX 341
Second Line : 85 CAMINO DEL OSO
City : PLACITAS
State : NM
Zip : 87043-0341
Country : US
Telephone Number : 575-312-7356
Fax Number :
Provider Business Practice Location Address
First Line : 9150 MCMAHON BLVD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87114-5201
Country : US
Telephone Number : 505-898-7986
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2015
Last Update Date : 01/05/2015

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Directions to “ PHILIP TOUPS PTA” Practice Location

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