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Organization

SPINE & MUSCLE REHABILITATION INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH G. ABBOTT (VICE PRESIDENT)
(505) 298-1558
Entity
Organization

Contact information

Practice address
10400 ACADEMY RD NE, SUITE #340, ALBUQUERQUE, NM 87111-7372
(505) 298-1558
(505) 298-7012
Mailing address
POB 20057, ALBUQUERQUE, NM 87154
(505) 298-1558
(505) 298-7012

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
4933
NM
172M00000X
Mechanotherapist
5499
NM
172M00000X
Mechanotherapist
6070
NM
174400000X
Specialist
R35692
NM
174400000X
Specialist
R38331
NM

Other

Enumeration date
07/08/2008
Last updated
09/21/2009
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