Individual
MR. ETTORE PITTORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2195 BOSQUE FARMS BLVD, BOSQUE FARMS, NM 87068-8941
(505) 916-0213
(505) 916-5063
Mailing address
1200 CAPITAN ST NW, LOS LUNAS, NM 87031-6924
(304) 963-0324
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
970
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT5194
NM BOARD OF PHYSICAL THERAPY
NM
Enumeration date
02/19/2010
Last updated
04/06/2018
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