Individual
MR. PHILIP MARTIN BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
7424 HOLLY AVE. NE, ALBUQUERQUE, NM 87113
(505) 797-5505
(505) 797-5510
Mailing address
8100 M4 WYOMING BLVD. NE, #261, ALBUQUERQUE, NM 87113-1956
(505) 797-5505
(505) 797-5510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2401
NM
Other
Enumeration date
03/02/2006
Last updated
08/20/2013
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