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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