Kali Bryan, PTA

Individual provider Active NPI Physical Therapy Assistant · Artesia, NM

NPI 1477030682 · NPPES record last updated Jul 20, 2018

Key facts

NPI
1477030682
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
PTA1524 (NM)
Practice address
2218 W Grand Ave
Artesia, NM 88210-1624
Phone
(575) 748-6100
NPI assigned
Jul 20, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PTA1524NMMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pecos Valley Regional Education Coop 8 Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA1524 NM Yes

Addresses

Primary practice location

2218 W Grand Ave
Artesia, NM 88210-1624

Mailing address

1100 Teak LN
Carlsbad, NM 88220-6621
Phone (303) 521-2396

Other providers in Artesia, NM

All providers in Artesia, NM · Physical Therapy Assistant in New Mexico

Sources for this page

Verify at the official NPI Registry.