Organization
SOUTHWEST THERAPY & REHABILITATION
Active
Other names
Star Ridsdale
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STAR AMBER RIDSDALE LMT (OWNER)
(505) 239-9644
Entity
Organization
Contact information
Practice address
1005 21ST ST SE, SUITE #9, RIO RANCHO, NM 87124-4030
(505) 239-9644
(505) 896-2958
Mailing address
10900 TANZANITE DR NW, ALBUQUERQUE, NM 87114-1853
(505) 239-9644
(505) 896-2958
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1435
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1435
STATE LIC. #
NM
Enumeration date
11/09/2006
Last updated
12/09/2016
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