Individual
TEISHA SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3501 N BUTLER AVE, SUITE 101, FARMINGTON, NM 87401-6429
(505) 326-0064
Mailing address
3501 N BUTLER AVE, SUITE 101, FARMINGTON, NM 87401-6429
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1054
NM
Other
Enumeration date
03/12/2016
Last updated
03/12/2016
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