Individual
ELLEN AMBA CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
132 ROMERO ST APT 4, SANTA FE, NM 87501-2572
(505) 988-2981
Mailing address
132 ROMERO ST APT 4, SANTA FE, NM 87501-2572
(505) 988-2981
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1498
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM00N024
BCBS PROVIDER #
NM
Enumeration date
04/10/2007
Last updated
07/08/2007
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