Individual
MS. JEANETTE FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
224 N CAMINO DEL PUEBLO, BERNALILLO, NM 87004-6146
(505) 404-2757
(505) 867-7891
Mailing address
224 N CAMINO DEL PUEBLO, BERNALILLO, NM 87004-6146
(505) 404-2757
(505) 867-7891
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2490
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B3707
—
NM
Enumeration date
09/27/2006
Last updated
07/09/2007
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