Organization
PHYSICAL THERAPY & SPORTS MEDICINE OF NORTHERN NEW MEXICO, INC.
Active
Organization
PHYSICAL THERAPY & SPORTS MEDICINE OF NORTHERN NEW MEXICO, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SID MOSIMAN PT (DIRECTOR)
(505) 334-9616
Entity
Organization
Contact information
Practice address
505 N MAIN AVE, AZTEC, NM 87410-1942
(505) 334-9616
(505) 334-7343
Mailing address
505 N MAIN AVE, AZTEC, NM 87410-1942
(505) 334-9616
(505) 334-7343
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1025
NM
225200000X
Physical Therapy Assistant
A-0483
NM
2255A2300X
Athletic Trainer
108
NM
Other
Enumeration date
04/10/2007
Last updated
10/07/2025
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