Provider Demographics
NPI:1518251479
Name:NORAH BISHOP PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:NORAH BISHOP PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:575-737-0715
Mailing Address - Street 1:PO BOX 2948
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-2948
Mailing Address - Country:US
Mailing Address - Phone:575-737-0715
Mailing Address - Fax:575-737-0601
Practice Address - Street 1:111 DONA ANA DR
Practice Address - Street 2:
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-4108
Practice Address - Country:US
Practice Address - Phone:575-737-0715
Practice Address - Fax:575-737-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty