Organization
E6 PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TED J ESPARZA PT (OWNER)
(505) 830-3678
Entity
Organization
Contact information
Practice address
3870 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 830-3678
(505) 830-6505
Mailing address
3870 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4479
(505) 830-3678
(505) 830-6505
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2523
NM
2251S0007X
Sports Physical Therapist
2523
NM
2251X0800X
Orthopedic Physical Therapist
2523
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38706539
—
NM
Enumeration date
10/24/2006
Last updated
05/04/2018
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