East Mountain Physical Therapy | |
2005b Us Route 66 West, Moriarty, NM 87035 | |
(505) 832-4011 | |
(505) 832-0434 |
Full Name | East Mountain Physical Therapy |
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Type | Facility |
Speciality | Physical Therapist |
Location | 2005b Us Route 66 West, Moriarty, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1669455994 | NPI | - | NPPES |
08028079 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 1036 (New Mexico) | Secondary |
225100000X | Physical Therapist | 1037 (New Mexico) | Secondary |
225100000X | Physical Therapist | 1852 (New Mexico) | Primary |
Provider Name | Maria L. "melu" Uriarte |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1689960882 PECOS PAC ID: 7810167491 Enrollment ID: I20110909002701 |
Provider Name | Cheryl Warren Fowler |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1518030287 PECOS PAC ID: 5395707699 Enrollment ID: I20120326000668 |
Provider Name | James Mark Fowler |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1649344276 PECOS PAC ID: 1759343049 Enrollment ID: I20120326000677 |
Provider Name | Jana R Covell |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1023141215 PECOS PAC ID: 7517196900 Enrollment ID: I20140205001065 |
Provider Name | Carolyn G Adie |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1982913851 PECOS PAC ID: 1456580851 Enrollment ID: I20140205001328 |
Provider Name | Brendan Moore |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1407211345 PECOS PAC ID: 1658770201 Enrollment ID: I20210601002587 |
Provider Name | Amanda C Macewen |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1548926140 PECOS PAC ID: 7315337854 Enrollment ID: I20211124000849 |
Provider Name | Roger W Taft |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1548308877 PECOS PAC ID: 1658767363 Enrollment ID: I20220406000693 |
Provider Name | Celia R Robinson |
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Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1922733229 PECOS PAC ID: 6103208145 Enrollment ID: I20220808000603 |
Provider Name | Gavin T Lynch |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1023790623 PECOS PAC ID: 3870948938 Enrollment ID: I20231009003428 |
Mailing Address | Practice Location Address |
---|---|
East Mountain Physical Therapy Po Box 1730, Moriarty, NM 87035-1730 Ph: (505) 832-4011 | East Mountain Physical Therapy 2005b Us Route 66 West, Moriarty, NM 87035 Ph: (505) 832-4011 |
Megan Servilla, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 Center St, Moriarty, NM 87035 Phone: 505-832-5817 | |
Mr. James Mark Fowler, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2005 W Us Route 66, Suite C, Moriarty, NM 87035 Phone: 505-832-4011 Fax: 505-832-0434 |