Individual
NICHOLAS IENNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2100 LOUISIANA BLVD NE STE 410, ALBUQUERQUE, NM 87110-5412
(505) 724-4300
(505) 724-4384
Mailing address
7307 E LEWIS AVE, SCOTTSDALE, AZ 85257-1426
(505) 553-6262
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
31586
AZ
225100000X
Physical Therapist
Primary
3366
NV
225100000X
Physical Therapist
PT2023-2062
NM
Other
Enumeration date
07/11/2016
Last updated
03/21/2023
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