Provider Demographics
NPI:1356668990
Name:FOUR POINT THERAPY, LLC
Entity Type:Organization
Organization Name:FOUR POINT THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LANPHERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-710-7668
Mailing Address - Street 1:173 EL CAMINO CAMPO
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-7518
Mailing Address - Country:US
Mailing Address - Phone:505-890-4117
Mailing Address - Fax:505-890-8345
Practice Address - Street 1:173 EL CAMINO CAMPO
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-7518
Practice Address - Country:US
Practice Address - Phone:505-890-4117
Practice Address - Fax:505-890-8345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-21
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1591225X00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty