Organization
SOUTHWEST SPORT AND SPINE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURIE DENISE CAMPBELL PT (DIRECTOR)
(505) 521-4188
Entity
Organization
Contact information
Practice address
2404 S LOCUST ST, STE 5, LAS CRUCES, NM 88001-5789
(505) 521-4188
(505) 521-3668
Mailing address
2404 S LOCUST ST, STE 5, LAS CRUCES, NM 88001-5789
(505) 521-4188
(505) 521-3668
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18402828
—
NM
Enumeration date
05/18/2006
Last updated
05/08/2008
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