Myles Sandoval, | |
980 Bosque Farms Blvd, Bosque Farms, NM 87068-9652 | |
(505) 554-0052 | |
Not Available |
Full Name | Myles Sandoval |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 980 Bosque Farms Blvd, Bosque Farms, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1992265458 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT6032 (New Mexico) | Secondary |
225100000X | Physical Therapist | 1316075 (Texas) | Primary |
Provider Name | Dux2 Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1629616974 PECOS PAC ID: 2567888563 Enrollment ID: O20200821000500 |
Mailing Address | Practice Location Address |
---|---|
Myles Sandoval, 145 Nara Visa Rd Nw, Albuquerque, NM 87107-6017 Ph: (512) 294-6479 | Myles Sandoval, 980 Bosque Farms Blvd, Bosque Farms, NM 87068-9652 Ph: (505) 554-0052 |
Bosque Therapy Center, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 980 Bosque Farms Blvd, Bosque Farms, NM 87068 Phone: 505-554-0052 Fax: 833-303-1343 | |
Mr. Ettore Pittore, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2195 Bosque Farms Blvd, Bosque Farms, NM 87068 Phone: 505-916-0213 Fax: 505-916-5063 |