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Organization

SW BRIAN INTEGRATION THERAPY & REHAB LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STAR AMBER RIDSDALE (OWNER)
(505) 239-9644
Entity
Organization

Contact information

Practice address
1005 21 ST. SE, SUITE # 4, RIO RANCHO, NM 87124
(505) 239-9644
(505) 896-2958
Mailing address
10900 TANZANITE DR NW, ALBUQUERQUE, NM 87114-1853
(505) 239-2958
(505) 896-2958

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
09/30/2010
Last updated
09/30/2010
About Stedi
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  • EDI platform