Gordon Henriksen

NPI #1386916583 in Aztec, New Mexico

Provider Information

NPI Number: 1386916583
Entity Type: Individual
Name: Gordon Henriksen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Feb 2, 2012
Last Updated: Feb 2, 2012

Practice Location

Address: 1607 W AZTEC BLVD
City: Aztec
State: New Mexico
ZIP Code: 87410-1805
Phone: (505) 334-3695

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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