Individual
MR. SID MOSIMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
505 N MAIN AVE, AZTEC, NM 87410-1942
(505) 334-9616
(505) 334-7343
Mailing address
505 N MAIN AVE, AZTEC, NM 87410-1942
(505) 334-9616
(505) 334-7343
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1025
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K0972
—
NM
Enumeration date
11/20/2006
Last updated
10/07/2025
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