Organization
PTP INC
Active
Other names
Physical Therapy Plus
Organization subpart
No
Provider details
NPI number
Authorized official
PETRA PIRC MSPT (PRESIDENT)
(505) 412-7735
Entity
Organization
Contact information
Practice address
1350 CENTRAL AVE STE 105, LOS ALAMOS, NM 87544-6217
(505) 662-3384
(505) 661-0084
Mailing address
1350 CENTRAL AVE STE 105, LOS ALAMOS, NM 87544-6217
(505) 662-3384
(505) 661-0084
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427544493
—
NM
Enumeration date
10/11/2019
Last updated
10/11/2019
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