Individual
DANIELLE VANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1910 AVENIDA LAS CAMPANAS NW, LOS RANCHOS, NM 87107-3204
(505) 908-0717
Mailing address
6116 POJOAQUE DR NW, ALBUQUERQUE, NM 87120-4475
(505) 218-3052
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1595
NM
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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