Anthony Lionel Arviso, PT

Individual provider Active NPI Physical Therapist · Gallup, NM

NPI 1548337009 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1548337009
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2151 (NM)
Practice address
1900 E Historic Highway 66
Suite 5
Gallup, NM 87301-4883
Phone
(505) 863-4199
Fax
(505) 863-4196
NPI assigned
Nov 29, 2006
Sex
Male
Sole proprietor
Yes

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 Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1900 E Historic Hwy 66
Suite 1
Gallup, NM 87301-4883

1900 E Hwy 66
Suite 1
Gallup, NM 87301-4883
Phone (505) 863-4199

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20111116000600 NM Practitioner - Physical Therapist in Private Practice 6002080694 Practice locations: Gallup, NM

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2151NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony L. Arviso Past
since Mar 5, 2011
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2151 NM Yes

Addresses

Primary practice location

1900 E Historic Highway 66
Suite 5
Gallup, NM 87301-4883

Mailing address

1900 E Historic Highway 66
Suite 5
Gallup, NM 87301-4883
Phone (505) 863-4199

Other providers in Gallup, NM

All providers in Gallup, NM · Physical Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.