Organization
LOS NINOS THERAPY CENTER
Active
Organization
LOS NINOS THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TONI ANN A. MARTINEZ PHYSICAL THERAPIST (PT/ADMINISTRATOR)
(505) 865-7955
Entity
Organization
Contact information
Practice address
336 LUNA AVENUE, LOS LUNAS, NM 87031
(505) 865-7955
(505) 866-7191
Mailing address
PO BOX 1436, LOS LUNAS, NM 87031-1436
(505) 865-7955
(505) 866-7191
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
695951
UNITED HEALTHCARE
NM
05
—
D0641
—
NM
05
—
K2312
—
NM
01
—
NN00N637
BLUE CROSS BLUE SHIELD
NM
01
—
QMYPR0072204
MOLINA HEALTHCARE OF NM
NM
Enumeration date
08/01/2006
Last updated
08/22/2020
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