| Ruidoso Physical Therapy Clinic, Inc | |
|
439 Mechem Dr, Ruidoso, NM 88345-6813 | |
| (575) 257-1800 | |
| (575) 257-2319 |
| Full Name | Ruidoso Physical Therapy Clinic, Inc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 439 Mechem Dr, Ruidoso, 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 |
|---|---|---|---|
| 1265498471 | NPI | - | NPPES |
| 000L2933 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1781 (New Mexico) | Primary |
| Provider Name | Lydia C Radosevich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1144236258 PECOS PAC ID: 6002853215 Enrollment ID: I20050409000004 |
| Provider Name | Kendall Gill |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073963641 PECOS PAC ID: 4082002555 Enrollment ID: I20231031003726 |
| Provider Name | Taylor Faust |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093260713 PECOS PAC ID: 5092002329 Enrollment ID: I20231228001581 |
| Mailing Address | Practice Location Address |
|---|---|
| Ruidoso Physical Therapy Clinic, Inc 439 Mechem Dr, Ruidoso, NM 88345-6813 Ph: (575) 257-1800 | Ruidoso Physical Therapy Clinic, Inc 439 Mechem Dr, Ruidoso, NM 88345-6813 Ph: (575) 257-1800 |
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 | |
Mr. Ian Christopher Paul, P.T. Physical Therapist Medicare: Medicare Enrolled Practice Location: 147 Mescalero Trl, Ruidoso, NM 88345 Phone: 575-257-5820 | |
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 |