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Organization

PHASE ZERO THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACOB MARTINEZ (OWNER)
(575) 202-2713
Entity
Organization

Contact information

Practice address
206 E 11TH ST, SILVER CITY, NM 88061-5503
(575) 202-2713
Mailing address
33 OLD LITTLE WALNUT RD, SILVER CITY, NM 88061-7629

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
3736
NM
235Z00000X
Speech-Language Pathologist
Primary
4714
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1366742074
NPI
01
1760512784
NPI
Enumeration date
06/28/2017
Last updated
06/29/2017
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