Individual
JACOBUS G VANZELST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1361 SARA WAY SE, RIO RANCHO, NM 87124-0999
(505) 377-3841
(505) 891-7811
Mailing address
1361 SARA WAY SE, RIO RANCHO, NM 87124-0999
(505) 377-3841
(505) 891-7811
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1012
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
48677876
—
NM
Enumeration date
01/09/2006
Last updated
10/21/2022
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