Individual
ARCHELLE JANE CAPUNDAG CALLEJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
177 CRAFT DR, ALAMOSA, CO 81101-2248
(719) 589-6425
Mailing address
925 LA DUE AVE, ALAMOSA, CO 81101-3242
(321) 960-0834
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0018675
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172190848
DRIVERS LICENCE
CO
Enumeration date
02/13/2023
Last updated
02/13/2023
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