Individual
VICTORIA TIAMZON AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 MASTHEAD ST NE STE 105, ALBUQUERQUE, NM 87109-4682
(505) 345-3754
Mailing address
1616 LEAD AVE SE, ALBUQUERQUE, NM 87106-4434
(505) 903-8469
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4938
NM
Other
Enumeration date
09/18/2018
Last updated
09/18/2018
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