Provider Demographics
NPI:1104033539
Name:BIRCHER, WENDY D (PT, EDD)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:D
Last Name:BIRCHER
Suffix:
Gender:F
Credentials:PT, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-9220
Mailing Address - Country:US
Mailing Address - Phone:505-566-3407
Mailing Address - Fax:505-566-3767
Practice Address - Street 1:608 REILLY AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-2634
Practice Address - Country:US
Practice Address - Phone:505-327-7720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist