Kidsbridge
NPI #1740556893 in Los Ranchos, New Mexico
Provider Information
- NPI Number
- 1740556893
- Entity Type
- Organization
- Organization Name
- Kidsbridge
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Mar 22, 2012
- Last Updated
- Mar 22, 2012
Practice Location
- Address
- 608 BLEDSOE RD NW
- City
- Los Ranchos
- State
- New Mexico
- ZIP Code
- 87107-6219
- Phone
- (505) 908-0717
Authorized Official
- Name
- MRS. KRISTEN S WIESE, MA OTR/L
- Title
- OWNER / OPERATOR
- Phone
- (505) 908-0717
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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