Provider Demographics
NPI:1417115999
Name:SANTA FE PHYSICAL THERAPY CENTER INC
Entity type:Organization
Organization Name:SANTA FE PHYSICAL THERAPY CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZUR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:505-470-6729
Mailing Address - Street 1:333 W CORDOVA RD
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1850
Mailing Address - Country:US
Mailing Address - Phone:505-984-9101
Mailing Address - Fax:505-984-8998
Practice Address - Street 1:333 W CORDOVA RD
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1850
Practice Address - Country:US
Practice Address - Phone:505-984-9101
Practice Address - Fax:505-984-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy