Liberty Javenia Ang, P.T.
Individual provider Active NPI Physical Therapist · Gallup, NM
NPI 1306962428 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1306962428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 3162 (NM)
- Practice address
- 1000 E Aztec Ave
Gallup, NM 87301-5509 - Phone
- (505) 721-1839
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3162 | NM | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3162 | NM | Yes |
Addresses
Primary practice location
1000 E Aztec Ave
Gallup, NM 87301-5509
Mailing address
1905 Merritt
Gallup, NM 87301-4808
Phone (505) 409-8290
Other providers in Gallup, NM
- Christina Ann Andrade
- Elizabeth Andrade
- Mary Melinda Andress
- Christie Andy
- Eleanor P Andy
- Anthony L. Arviso
- Becky Lynn Anton
- Brittany N Antonio
- Priscilla Antonio
- Apexnetwork New Mexico, LLC
All providers in Gallup, NM · Physical Therapist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.