Organization
INNOVATIONS HEALTHCARE REHABILITATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BERNARDO CORNEJO PT (OWNER)
(575) 556-9568
Entity
Organization
Contact information
Practice address
755 S TELSHOR BLVD, A201, LAS CRUCES, NM 88011-4688
(575) 556-9568
(575) 556-9569
Mailing address
5971 CORN HUSK LN, EL PASO, TX 79932-2303
(575) 556-9568
(575) 556-9569
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3112
NM
Other
Enumeration date
05/20/2008
Last updated
05/08/2012
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