Organization
ELITE PHYSIQUE PERFORMANCE TRAINING, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN NEWMAN (PRESIDENT / OWNER)
(505) 377-7539
Entity
Organization
Contact information
Practice address
5740 NIGHT WHISPER RD NW, ALBUQUERQUE, NM 87114-1575
(505) 377-7539
Mailing address
2325 CORTINA LOOP SE, RIO RANCHO, NM 87124-8933
(505) 377-7539
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11423NMPFT
NM
261QR0400X
Rehabilitation Clinic/Center
Primary
11423NMPFT
NM
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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