Organization
PATIENCE GRASSHOPPER THERAPEUTICS
Active
Other names
Elliott Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
AMILIA ANNE ELLIOTT M.P.T. (OWNER, PROVIDER)
(575) 756-8391
Entity
Organization
Contact information
Practice address
16306 B HWY 84, CHAMA, NM 87520
(575) 756-8391
Mailing address
PO BOX 301, CHAMA, NM 87520-0301
(575) 756-8391
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2983
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67509533
—
NM
01
—
NMOOQ782
BCBS
NM
Enumeration date
07/05/2011
Last updated
07/05/2011
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