Individual
MR. MARCEL MILLADO MODELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1692B HOSPITAL DR, SANTA FE, NM 87505-4825
(505) 982-6399
(505) 982-3219
Mailing address
1692B HOSPITAL DR, SANTA FE, NM 87505-4825
(505) 982-6399
(505) 982-3219
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-0777
NM
Other
Enumeration date
10/03/2017
Last updated
10/03/2017
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