Individual
KATHLEEN A ALCON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1398 WEIMER RD, STE 203, TAOS, NM 87571
(575) 737-0304
(575) 737-0383
Mailing address
1398 WEIMER RD, STE 203, TAOS, NM 87571
(575) 737-0304
(575) 737-0383
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
453
NM
225100000X
Physical Therapist
2858
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43383386
—
NM
Enumeration date
08/31/2006
Last updated
01/27/2013
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