Provider Demographics
NPI:1346430311
Name:ZUFLACHT, DAVID (PT, MSC, DPT, PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ZUFLACHT
Suffix:
Gender:M
Credentials:PT, MSC, DPT, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:DULCE
Mailing Address - State:NM
Mailing Address - Zip Code:87528-0187
Mailing Address - Country:US
Mailing Address - Phone:575-759-7249
Mailing Address - Fax:575-759-7294
Practice Address - Street 1:500 N MUNDO
Practice Address - Street 2:
Practice Address - City:DULCE
Practice Address - State:NM
Practice Address - Zip Code:87528
Practice Address - Country:US
Practice Address - Phone:575-759-3291
Practice Address - Fax:575-759-3532
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIVI69225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist