Provider Demographics
NPI:1881587210
Name:NELSON, RYLEY MCBRIDE (DPT)
Entity type:Individual
Prefix:
First Name:RYLEY
Middle Name:MCBRIDE
Last Name:NELSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9108 SURREY RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6802
Mailing Address - Country:US
Mailing Address - Phone:505-480-6463
Mailing Address - Fax:
Practice Address - Street 1:6100 JEFFERSON ST NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3493
Practice Address - Country:US
Practice Address - Phone:505-948-4555
Practice Address - Fax:505-508-1406
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT-2025-0140225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist