Individual
KAITLYN VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
628 SUDDERTH DR, RUIDOSO, NM 88345-6204
(575) 257-5820
Mailing address
PO BOX 7100, RUIDOSO, NM 88355-7100
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
03/04/2015
Last updated
05/09/2017
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