Individual
ANNETTE WEYRAUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
1350 CENTRAL AVE, SUITE 105, LOS ALAMOS, NM 87544-3244
(505) 662-3384
(505) 661-0085
Mailing address
1350 CENTRAL AVE, SUITE 105, LOS ALAMOS, NM 87544-3244
(505) 662-3384
(505) 661-0085
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
833
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NM00N615
BCBS
NM
01
—
201079524
PRESBYTERIAN
NM
Enumeration date
10/18/2006
Last updated
11/22/2011
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