Provider Demographics
NPI:1174992689
Name:QUINTAL CALVA, NORA J (DPT)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:J
Last Name:QUINTAL CALVA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:J
Other - Last Name:QUINTAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:410 TULANE DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1418
Mailing Address - Country:US
Mailing Address - Phone:505-615-9381
Mailing Address - Fax:505-431-3170
Practice Address - Street 1:3538 ANDERSON AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1612
Practice Address - Country:US
Practice Address - Phone:505-615-9381
Practice Address - Fax:505-431-3157
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist