Individual
DR. TATENDA CHIBANGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
808 CHAMISAL RD NW, LOS RANCHOS, NM 87107-6408
(505) 720-9049
Mailing address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5500
NM
Other
Enumeration date
06/27/2019
Last updated
10/31/2024
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