Provider Demographics
NPI:1568662344
Name:TAHYI, JO ANNA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANNA
Last Name:TAHYI
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:JO
Other - Middle Name:ANNA
Other - Last Name:FARIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:4600 MONTGOMERY BLVD NE
Mailing Address - Street 2:BUILDING D, SUITE 100
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1210
Mailing Address - Country:US
Mailing Address - Phone:505-343-6320
Mailing Address - Fax:505-343-6365
Practice Address - Street 1:4600 MONTGOMERY BLVD NE
Practice Address - Street 2:BUILDING D, SUITE 100
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1210
Practice Address - Country:US
Practice Address - Phone:505-343-6320
Practice Address - Fax:505-343-6365
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist