Individual
MARK ALEXIS BALVERDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9500
Mailing address
1350 HILLRISE CIR, LAS CRUCES, NM 88011-4759
(575) 522-9500
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
11240
CT
225100000X
Physical Therapist
Primary
5157
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B416-541-88-443-0
DRIVER'S LICENSE NUMBER
FL
Enumeration date
11/28/2017
Last updated
05/24/2019
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