Espanola Sports Medicine

LBN: Espanola Sports Medicine, Pa
Espanola Sports Medicine is an health care organization with primary practice located at 708 La Joya St , Espanola NM 87532-2511. The organization recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Ambulatory Health Care Facilities / Physical Therapy, Ambulatory Health Care Facilities / Rehabilitation. Ambulatory Health Care Facilities / Rehabilitation is the primary health care specialty. Espanola Sports Medicine, Pa can be contacted via phone (505) 753-6550, or through Godfrey, Theresa Lynn via phone (402) 334-1919.

Contact Information

Primary practice address
708 La Joya St Espanola NM 87532-2511
Phone: (505) 753-6550
Fax: (505) 753-1219
Website:
Map and Directions
Authorized official contact:
Name: Godfrey, Theresa Lynn
Phone: (402) 334-1919

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 6628 New Mexico
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X 6628 New Mexico
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X

Profile Details

NPI number 1982777850
LBN Legal business name Espanola Sports Medicine, Pa
DBA Doing business as Espanola Sports Medicine
Authorized official Godfrey, Theresa Lynn
Entity Organization
Organization subpart 1 No
Enumeration date Nov 16th, 2006
Last updated Oct 31st, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982777850 NPPES
New Mexico MEDICAID R5803

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