Individual
SEAN A SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
01 SAGEBRUSH, ISELETA, NM 87022
(505) 869-4398
Mailing address
PO BOX 640, ISLETA, NM 87022-0640
(505) 869-3200
(505) 869-4881
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5317
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT5317
LICENSE
NM
Enumeration date
11/26/2019
Last updated
11/26/2019
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