Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2822 | NM |
NPI | 1124098264 |
---|---|
Provider Name | Tanya W Call |
First Address | Albuquerque, NM 87111 |
Second Address | Albuquerque, NM 87108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 08/07/2007 |