Provider Demographics
NPI:1538865043
Name:METHOD PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:METHOD PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST AND CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORA
Authorized Official - Middle Name:JACKELINE
Authorized Official - Last Name:QUINTAL CALVA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:505-250-8401
Mailing Address - Street 1:410 TULANE DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1418
Mailing Address - Country:US
Mailing Address - Phone:505-615-9381
Mailing Address - Fax:
Practice Address - Street 1:3538 ANDERSON AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1612
Practice Address - Country:US
Practice Address - Phone:505-615-9381
Practice Address - Fax:505-431-3170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1174992689OtherNPI