IndividualActive
Jose Rivas
NPI 1083167373 · Athletic Trainer · Edgewood, NM
Provider details
- NPI number
- 1083167373
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 511309484 (NM)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
60 Range Rd
Edgewood, NM 87015-9028
Phone: (505) 620-6676
Approximate (ZIP-level) locationGet directions
Mailing address
60 Range Rd
Edgewood, NM 87015-9028
Registry dates
- Enumerated
- 2016-08-03
- Last updated
- 2016-08-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.