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Individual

NICK D. ABEYTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
612 TERRACE AVENUE, CHAMA, NM 87520-0976
(505) 756-4024
Mailing address
PO BOX 976, CHAMA, NM 87520-0976
(505) 756-4024

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
642
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000K3526
NM
01
HSZ196
MEDICARE PART B
NM
Enumeration date
10/31/2006
Last updated
05/28/2008
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