| Mr Ian Christopher Paul, PT | |
|
147 Mescalero Trl, Ruidoso, NM 88345-6090 | |
| (575) 257-5820 | |
| Not Available |
| Full Name | Mr Ian Christopher Paul |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 147 Mescalero Trl, Ruidoso, 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 |
|---|---|---|---|
| 1093046393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 3453 (New Mexico) | Primary |
| Provider Name | Fowler Enterprises Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1669455994 PECOS PAC ID: 6305808692 Enrollment ID: O20041029000133 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Ian Christopher Paul, PT Po Box 7100, Ruidoso, NM 88355-7100 Ph: (575) 257-5820 | Mr Ian Christopher Paul, PT 147 Mescalero Trl, Ruidoso, NM 88345-6090 Ph: (575) 257-5820 |
Mrs. Roberta Renee Regalado, M.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 628 Sudderth Dr, Ruidoso, NM 88345 Phone: 575-257-5820 Fax: 575-257-9560 | |
Mr. Ryan David Biricocchi, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 147 Mescalero Trl, Ruidoso, NM 88345 Phone: 505-257-5820 Fax: 505-257-9560 | |
Dana M Wade, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1129 Mechem Dr Ste C, Ruidoso, NM 88345 Phone: 575-808-8721 Fax: 575-808-8723 | |
Lydia C. Radosevich, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 439 Mechem Dr, Ruidoso, NM 88345 Phone: 505-257-1800 Fax: 505-257-2319 | |
Marla Loree Wall, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 147 Mescalero Trl, Ruidoso, NM 88345 Phone: 575-257-5820 | |
Ruidoso Physical Therapy Clinic, Inc Physical Therapist Medicare: Medicare Enrolled Practice Location: 439 Mechem Dr, Ruidoso, NM 88345 Phone: 575-257-1800 Fax: 575-257-2319 |