Individual
MR. BRIAN JAMES REWALT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2455 MISSOURI AVE, LAS CRUCES, NM 88001-5122
(575) 522-5852
Mailing address
2455 MISSOURI AVE, LAS CRUCES, NM 88001-5122
(575) 522-5852
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2059
NM
Other
Enumeration date
01/09/2008
Last updated
01/09/2008
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