Provider Demographics
NPI:1114632312
Name:TURLEY, NATHAN (DPT)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:TURLEY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 MESSINA DR STE 108
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-4780
Mailing Address - Country:US
Mailing Address - Phone:505-258-4003
Mailing Address - Fax:505-436-2740
Practice Address - Street 1:3701 MESSINA DR STE 108
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-4780
Practice Address - Country:US
Practice Address - Phone:505-258-4003
Practice Address - Fax:505-436-2740
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT22053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist