Organization
MOVEMENT AND PERFORMANCE OF NEW MEXICO
Active
Organization
MOVEMENT AND PERFORMANCE OF NEW MEXICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE L BACA PT (PHYSICAL THERAPIST/OWNER)
(505) 250-7049
Entity
Organization
Contact information
Practice address
1612 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-4437
(505) 250-7049
Mailing address
1612 RIDGECREST DR SE, ALBUQUERQUE, NM 87108-4437
(505) 250-7049
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
3533
NM
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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