Provider Demographics
NPI:1598391138
Name:T OR C PHYSICAL THERAPY
Entity type:Organization
Organization Name:T OR C PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:DIGESU
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:575-894-8029
Mailing Address - Street 1:PO BOX 3685
Mailing Address - Street 2:
Mailing Address - City:TRUTH OR CONSEQUENCES
Mailing Address - State:NM
Mailing Address - Zip Code:87901-3685
Mailing Address - Country:US
Mailing Address - Phone:575-894-8029
Mailing Address - Fax:575-894-8029
Practice Address - Street 1:219 DR. HUBBLE DRIVE
Practice Address - Street 2:
Practice Address - City:TRUTH OR CONSEQUENCES
Practice Address - State:NM
Practice Address - Zip Code:87901-3685
Practice Address - Country:US
Practice Address - Phone:575-894-8029
Practice Address - Fax:575-894-8029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy