Organization
RUIDOSO PHYSICAL THERAPY CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LYDIA C. RADOSEVICH P.T. (OWNER/THERAPIST)
(575) 257-1800
Entity
Organization
Contact information
Practice address
439 MECHEM DR, RUIDOSO, NM 88345-6813
(575) 257-1800
(575) 257-2319
Mailing address
439 MECHEM DR, RUIDOSO, NM 88345-6813
(575) 257-1800
(575) 257-2319
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1781
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000L2933
—
NM
Enumeration date
04/25/2006
Last updated
08/29/2022
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