Individual
EILEEN FARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
170 SEDILLO HILL RD, TIJERAS, NM 87059-7318
(505) 553-5371
Mailing address
170 SEDILLO HILL RD, TIJERAS, NM 87059-7318
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1164
NM
Other
Enumeration date
01/19/2015
Last updated
01/19/2015
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