Individual
TERESA MARIE OLIVAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MPT
Contact information
Practice address
2404 S LOCUST ST, SUITE 5, LAS CRUCES, NM 88001-5789
(505) 521-4188
(505) 521-3668
Mailing address
2404 S LOCUST ST, SUITE 5, LAS CRUCES, NM 88001-5789
(505) 521-4188
(505) 521-3668
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3287
NM
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
3287
NM
2251X0800X
Orthopedic Physical Therapist
3287
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21307580
—
NM
01
—
NM00Q602
BCBS NM
NM
Enumeration date
08/17/2006
Last updated
02/10/2023
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