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NPI Code Detail

MEDICARE: MS. GLENNA C ALLENBERG LPTA

MEDICARE:  MS. GLENNA C ALLENBERG  LPTA
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-0398NM

General Provider Information

NPI Number : 1649319088
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GLENNA C ALLENBERG LPTA
Provider Business Mailing Address
First Line : 1817 S 6TH ST
Second Line :
City : TUCUMCARI
State : NM
Zip : 88401-3655
Country : US
Telephone Number : 505-403-6457
Fax Number :
Provider Business Practice Location Address
First Line : 301 E MIEL DE LUNA AVE
Second Line :
City : TUCUMCARI
State : NM
Zip : 88401-3810
Country : US
Telephone Number : 505-461-7233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2007
Last Update Date : 07/08/2007

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Directions to “ MS. GLENNA C ALLENBERG LPTA” Practice Location

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