Individual
MAESELLE TISSNOLTHTOS LA PAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1280 N MILDRED RD, STE 2, CORTEZ, CO 81321-2212
(970) 564-0311
(970) 564-0313
Mailing address
1280 N MILDRED RD, STE 2, CORTEZ, CO 81321-2212
(970) 564-0311
(970) 564-0313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT5767
NM
225100000X
Physical Therapist
Primary
PTL.0017554
CO
Other
Enumeration date
11/02/2020
Last updated
09/21/2021
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