Individual
MR. MICHAEL L MCFALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
932 GALLINAS ST, SUITE 103, LAS VEGAS, NM 87701-3891
(505) 425-7762
(505) 454-0801
Mailing address
2810 HOT SPRINGS BLVD STE A, LAS VEGAS, NM 87701-4119
(505) 425-7762
(505) 454-0801
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1132
NM
225100000X
Physical Therapist
Primary
1132
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39185885
—
NM
Enumeration date
11/07/2006
Last updated
04/09/2020
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