Individual
GINA DIMACULANGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 SOUTH PACHECO STREET, SANTA FE, NM 87505
(561) 969-8505
Mailing address
2401 SOUTH PACHECO STREET, SANTA FE, NM 87505
(561) 969-8505
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1247702
TX
225100000X
Physical Therapist
Primary
PT-4894
NM
Other
Enumeration date
09/19/2016
Last updated
08/19/2021
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