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Individual

MR. REUEL JOSEPH TRIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
300 N KENTUCKY AVE, ROSWELL, NM 88201-4636
(505) 625-2571
(505) 627-2544
Mailing address
700 N MISSOURI AVE APT 20, ROSWELL, NM 88201-4860
(505) 317-8559

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211438
VA
225100000X
Physical Therapist
3236
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
72021888
NM
Enumeration date
01/16/2007
Last updated
08/06/2019
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