Provider Demographics
NPI:1770069478
Name:FUSTING, ERIN M (DPT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:FUSTING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 ACADEMY LN
Mailing Address - Street 2:
Mailing Address - City:TAOS
Mailing Address - State:NM
Mailing Address - Zip Code:87571-6416
Mailing Address - Country:US
Mailing Address - Phone:970-708-7031
Mailing Address - Fax:
Practice Address - Street 1:1307 PASEO DEL PUEBLO NORTE
Practice Address - Street 2:
Practice Address - City:EL PRADO
Practice Address - State:NM
Practice Address - Zip Code:87529
Practice Address - Country:US
Practice Address - Phone:575-770-5661
Practice Address - Fax:575-221-0424
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist