Organization
LA LUZ THERAPY SERVICES
Active
Organization
LA LUZ THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISA RODDY (OWNER)
(505) 363-9582
Entity
Organization
Contact information
Practice address
5400 SEVILLA AVE NW STE E, ALBUQUERQUE, NM 87120-1853
(505) 363-9582
(505) 214-5137
Mailing address
1312 MESA WOOD PL NW, ALBUQUERQUE, NM 87120-6565
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
4196
NM
261QP2000X
Physical Therapy Clinic/Center
4197
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730501883
NPI
NM
01
—
1972853026
NPI
NM
Enumeration date
03/04/2017
Last updated
11/30/2019
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