Organization · Type 2 NPI

Taos Sports Medicine Serices LLC

Orthopedic Physical Therapist · Angel Fire, NM

NPI number 1659689347 Active

Practice location

12 Crestview Drive, Ste 1S
Angel Fire, NM 87710-0489

Call (575) 377-1900 Map

Fax (575) 377-2383

Mailing address

1398 Weimer Rd, Ste 203
Taos, NM 87571-6397

Specialties and licenses

Taxonomy	Code	License
Orthopedic Physical Therapist Primary	2251X0800X	3072B1 (NM)

Orthopedic Physical Therapist: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based prac…

NPI record

NPI: 1659689347
Entity type: Organization (Type 2)
Issued: Sep 16, 2010
Last updated: Sep 16, 2010
Status: Active
Subpart: Yes of Taos Sports Medicine Services, LLC

Other names

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Angel Fire Physical Therapy · doing business as

Authorized official

Jocelyn Lucero
Office Manager
(575) 737-0304

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1659689347

Taos Sports Medicine Serices LLC's National Provider Identifier is 1659689347, issued on Sep 16, 2010. The primary taxonomy on file is Orthopedic Physical Therapist (2251X0800X), and the practice location is in Angel Fire, NM. The record was last updated on Sep 16, 2010.