Organization
PRACTICAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER CORDOVA (OWNER)
(505) 980-9477
Entity
Organization
Contact information
Practice address
8147 WESTOVER PL NW, ALBUQUERQUE, NM 87120-5529
(505) 980-9477
(505) 867-1392
Mailing address
8147 WESTOVER PL NW, ALBUQUERQUE, NM 87120-5529
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
FA0053722
NM
Other
Enumeration date
05/30/2007
Last updated
08/22/2020
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