Provider Demographics
NPI:1316485352
Name:LEVEL PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:LEVEL PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, ATC
Authorized Official - Phone:505-750-3033
Mailing Address - Street 1:2801 GIRARD BLVD NE
Mailing Address - Street 2:STE L
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87107-1936
Mailing Address - Country:US
Mailing Address - Phone:505-750-3033
Mailing Address - Fax:505-738-0360
Practice Address - Street 1:2801 GIRARD BLVD NE
Practice Address - Street 2:STE L
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-1936
Practice Address - Country:US
Practice Address - Phone:505-750-3033
Practice Address - Fax:505-738-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4210261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy