Provider Demographics
NPI:1346329547
Name:HIGGINS, RONNE LEE (PT)
Entity Type:Individual
Prefix:
First Name:RONNE
Middle Name:LEE
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10008 CHANTILLY RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4211
Mailing Address - Country:US
Mailing Address - Phone:505-883-5228
Mailing Address - Fax:
Practice Address - Street 1:10008 CHANTILLY RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4211
Practice Address - Country:US
Practice Address - Phone:505-883-5228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2292225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist