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Individual

RACHAEL E HAVERPORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1011 10TH ST, A, ALAMOGORDO, NM 88310-6425
(575) 439-9878
(575) 439-9876
Mailing address
2436 CHERRY HILLS DR, ALAMOGORDO, NM 88310-7740
(575) 439-9878
(575) 439-9876

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4296
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4296
PHYSICAL THERAPY LICENSE
NM
Enumeration date
06/09/2013
Last updated
06/09/2013
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