Individual
TONY FLORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3832 E MAIN ST, STE E, FARMINGTON, NM 87402-8749
(505) 258-4003
(505) 436-2740
Mailing address
1110 W OMAHA ST, STE 3, RAPID CITY, SD 57701-8120
(605) 721-5950
(605) 721-5940
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A-0388
LICENSE #
NM
Enumeration date
09/06/2006
Last updated
02/10/2015
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