Organization
ALTAVISTA HEALTHCARE GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANCA CORRIE (CEO)
(210) 249-4949
Entity
Organization
Contact information
Practice address
154 E MYRTLE AVE STE 100, MURRAY, UT 84107-4850
(210) 249-4949
Mailing address
14439 NW MILITARY HWY STE 449, SHAVANO PARK, TX 78231-1646
(210) 249-4949
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
09/12/2018
Last updated
09/12/2018
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