Individual
MS. TANYA LYNNE CILLESSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4520 MONTGOMERY BLVD NE, SUITE 4, ALBUQUERQUE, NM 87109-1217
(505) 872-9882
(505) 881-4838
Mailing address
PO BOX 46123, RIO RANCHO, NM 87174
(505) 872-9882
(505) 881-4838
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1376
NM
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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