Organization
THI OF NEW MEXICO THERAPY, LLC
Active
Organization
THI OF NEW MEXICO THERAPY, LLC
Active
Other names
BalanceOne Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WENCLAWIAK III (PRESIDENT)
(505) 828-2400
Entity
Organization
Contact information
Practice address
8814 HORIZON BLVD NE, ALBUQUERQUE, NM 87113-1689
(505) 828-2400
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96839031
—
NM
Enumeration date
05/05/2006
Last updated
03/10/2008
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