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Individual

KYRA J SAAVEDRA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1200 MICHIGAN ST. SOCORRO HIGH SCHOOL, SOCORRO, NM 87801
(575) 838-3112
Mailing address
1200 MICHIGAN ST. SOCORRO HIGH SCHOOL, SOCORRO, NM 87801
(575) 838-3112

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
365343
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
120985388
NM
Enumeration date
09/01/2020
Last updated
09/01/2020
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