Individual
TAYLOR VICTORIA BUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1692B HOSPITAL DR STE 202, SANTA FE, NM 87505-4825
(505) 982-6399
(505) 982-3219
Mailing address
120 TOPSPIN CIR, SPICEWOOD, TX 78669-3179
(409) 779-6158
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2023-2293
NM
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69987254
—
NM
Enumeration date
05/16/2022
Last updated
10/31/2024
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