Individual
JUSTIN DANIEL BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3811 COMMONS AVE NE, ALBUQUERQUE, NM 87109-5832
(505) 345-9599
Mailing address
3811 COMMONS AVE NE, ALBUQUERQUE, NM 87109-5832
(505) 345-9599
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NM
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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