Organization
NEW MEXICO SPORTS & PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DINO J PINO (DIRECTOR)
(505) 424-0131
Entity
Organization
Contact information
Practice address
1631 HOSPITAL DR, SUITE 220, SANTA FE, NM 87505-4728
(505) 424-0131
(505) 795-7073
Mailing address
2954 RODEO PARK DR. WEST, SANTA FE, NM 87505-4728
(505) 424-0131
(505) 795-7032
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
6292
NM
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N4536
—
NM
Enumeration date
01/19/2007
Last updated
06/15/2017
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