Organization
INDIGO THERAPY SERVICES, INC.
Active
Organization
INDIGO THERAPY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY B DILLARD (OWNER-VICE PRESIDENT)
(505) 508-0505
Entity
Organization
Contact information
Practice address
7103 4TH ST NW, SUITE C, ALBUQUERQUE, NM 87107-6641
(505) 508-0505
(505) 508-0505
Mailing address
6817 ACADEMY PARKWAY WEST NE, ALBUQUERQUE, NM 87109-4405
(505) 508-0505
(505) 312-8414
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
423
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53321006
—
NM
Enumeration date
12/05/2009
Last updated
01/09/2019
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