Individual
MYLES SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
980 BOSQUE FARMS BLVD, BOSQUE FARMS, NM 87068-9652
(505) 554-0052
Mailing address
145 NARA VISA RD NW, ALBUQUERQUE, NM 87107-6017
(512) 294-6479
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1316075
TX
225100000X
Physical Therapist
PT6032
NM
Other
Enumeration date
03/21/2019
Last updated
10/27/2022
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