Provider Demographics
NPI:1124864699
Name:PHYSICAL THERAPY PARTNERS LLC
Entity type:Organization
Organization Name:PHYSICAL THERAPY PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BLANKFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:505-240-0315
Mailing Address - Street 1:582 OSO RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:GRANTS
Mailing Address - State:NM
Mailing Address - Zip Code:87020-9404
Mailing Address - Country:US
Mailing Address - Phone:505-240-0315
Mailing Address - Fax:
Practice Address - Street 1:582 OSO RIDGE RD
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-9404
Practice Address - Country:US
Practice Address - Phone:505-240-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care