Individual
ROBERT J PATTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2351 INDIAN WELLS, ALAMOGORDO, NM 88310-5012
(575) 439-1397
Mailing address
PO BOX 2860, ALAMOGORDO, NM 88311-2860
(575) 439-1397
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
827
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79263
—
NM
01
—
NM00Q162
BLUE CROSS BLUE SHIELD
NM
Enumeration date
08/25/2005
Last updated
06/10/2011
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