Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Function and Form Physical Therapy LLC

Organization Physical Therapist · NPI 1124646294

Function and Form Physical Therapy LLC is a Physical Therapist in Santa Teresa, New Mexico. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5312 Rio Bravo Dr Ste 7
Santa Teresa, NM 88008-9210
Phone: (575) 201-3764
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1124646294
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Derrick Delgado — Member · (915) 777-1749
NPI enumeratedJuly 6, 2020
Last updated in NPPESMarch 28, 2021
Certification dateMarch 28, 2021
Mailing address5312 Rio Bravo Dr Ste 7, Santa Teresa, NM 88008-9210

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