Individual
TALOA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4210 SABANA GRANDE AVE SE, RIO RANCHO, NM 87124-1152
(505) 892-6603
Mailing address
4210 SABANA GRANDE AVE SE, RIO RANCHO, NM 87124-1152
(505) 892-6603
(505) 891-8774
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1450
NM
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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