Wade, Dana M
Wade, Dana M is an sole proprietor health care provider with primary practice located at 1129 Mechem Dr Ste C , Ruidoso NM 88345-7292. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Wade, Dana M can be contacted via phone (575) 808-8721.Contact Information
Primary practice address
1129 Mechem Dr Ste C
Ruidoso NM 88345-7292
Phone: (575) 808-8721
Fax: (575) 808-8723
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 3987 | New Mexico |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 1087419 | Texas |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT3987 | New Mexico |
Profile Details
| NPI number | 1063658706 |
|---|---|
| LBN Legal business name | Wade, Dana M |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 31st, 2008 |
| Last updated | Apr 30th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063658706 | NPPES |
| New Mexico | MEDICAID | 12757349 |
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