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Organization

NEW MEXICO PHYSICAL THERAPISTS DBA VIBRANTCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER NICHOLSON (HR)
(800) 421-1965
Entity
Organization

Contact information

Practice address
2211C MAIN ST SE, LOS LUNAS, NM 87031-8297
(505) 866-1677
(505) 866-1767
Mailing address
2270 DOUGLAS BLVD STE 112, ROSEVILLE, CA 95661-4239
(800) 421-1965
(916) 773-1481

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3896
NM

Other

Enumeration date
09/30/2010
Last updated
09/30/2010
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