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

Physical Therapy & Sports Medicine of Northern New Mexico, Inc

Organization Physical Therapist · NPI 1306069224

Physical Therapy & Sports Medicine of Northern New Mexico, Inc is a Physical Therapist in Aztec, New Mexico. Works from 2 locations. Licensed in New Mexico.

Licensed in
NM
In the registry since
2007
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

505 N Main Ave
Aztec, NM 87410-1942
Phone: (505) 334-9616
Fax: (505) 334-7343
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 660 E Broadway Ave, Bloomfield, NM 87413-6601 — (505) 632-4550

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1025 (NM)
Physical Therapy Assistant Taxonomy 225200000X · Licence A-0483 (NM)
Athletic Trainer Taxonomy 2255A2300X · Licence 108 (NM)

Record details

NPI number1306069224
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sid Mosiman — Director · (505) 334-9616
NPI enumeratedApril 10, 2007
Last updated in NPPESOctober 7, 2025
Certification dateOctober 7, 2025
Mailing address505 N Main Ave, Aztec, NM 87410-1942

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