Individual
KEISHLA COTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
100 EAST MANANA BLVD, UNIT 1, CLOVIS, NM 88101
(575) 366-5014
Mailing address
3308 LEW WALLACE DR, CLOVIS, NM 88101
(575) 693-3431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3421
NM
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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