Individual
MRS. SHEILA MARIE BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3701 MESSINA DR STE 108, FARMINGTON, NM 87402-4780
(505) 258-4003
Mailing address
3701 MESSINA DR STE 108, FARMINGTON, NM 87402-4780
(505) 258-4003
(505) 436-2740
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-1422
NM
Other
Enumeration date
07/30/2019
Last updated
07/30/2019
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