Organization
PA MEDICAL REHAB CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ORELVIS LOPEZ CASTILLO (PRESIDENT)
(505) 582-1780
Entity
Organization
Contact information
Practice address
2900 LOUISIANA BLVD NE STE H, ALBUQUERQUE, NM 87110-3565
(505) 582-1780
Mailing address
2900 LOUISIANA BLVD NE SUITE H, ALBUQUERQUE, NM 87110
(505) 582-1780
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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