Tatenda Chibanga, PT, DPT

Individual provider Active NPI Physical Therapist · Los Ranchos, NM

NPI 1639730856 · NPPES record last updated Oct 31, 2024

Key facts

NPI
1639730856
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT5500 (NM)
Practice address
808 Chamisal Rd NW
Los Ranchos, NM 87107-6408
Phone
(505) 720-9049
NPI assigned
Jun 27, 2019
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Think Back Inc Physical Therapist Current
since Aug 13, 2019
Accepting new patients
Think Back Inc Physical Therapist Past
since Aug 13, 2019
Accepting new patients

Locations

2516 Vermont St NE
Albuquerque, NM 87110
Phone (505) 883-7518

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5500 NM Yes

Addresses

Primary practice location

808 Chamisal Rd NW
Los Ranchos, NM 87107-6408

Mailing address

1501 San Pedro Dr SE
Albuquerque, NM 87108-5153
Phone (505) 265-1711

Other providers in Los Ranchos, NM

All providers in Los Ranchos, NM · Physical Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.