Individual
SPRING BEAVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8 CALLE MEDICO, SANTA FE, NM 87505-4724
(505) 424-8777
Mailing address
3005 S ST FRANCIS DR. #461, STE 1-D, SANTA FE, NM 87505
(505) 977-7331
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1471
NM
Other
Enumeration date
10/24/2019
Last updated
10/24/2019
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