Organization
PHYSICAL THERAPY CENTER, LLC
Active
Organization
PHYSICAL THERAPY CENTER, LLC
Active
Other names
Physical Therapy Center
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN ARDEN KANODE DPT (OWNER)
(505) 454-1213
Entity
Organization
Contact information
Practice address
1607 7TH ST STE C, LAS VEGAS, NM 87701-4952
(505) 454-1213
Mailing address
PO BOX 2694, LAS VEGAS, NM 87701-2694
(505) 454-1213
(505) 425-2798
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4234
NM
261QP2000X
Physical Therapy Clinic/Center
Primary
4234
NM
Other
Enumeration date
11/17/2012
Last updated
06/18/2014
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