Healthcare Provider Details

I. General information

NPI: 1184981458
Provider Name (Legal Business Name): OCCUPATIONAL THERAPY SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W HEMLOCK ST
DEMING NM
88030-3622
US

IV. Provider business mailing address

5000 MOTHER LODE TRL
LAS CRUCES NM
88011-8370
US

V. Phone/Fax

Practice location:
  • Phone: 575-644-2214
  • Fax:
Mailing address:
  • Phone: 575-644-2214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNM

VIII. Authorized Official

Name: HENRY ROWLISON
Title or Position: PRESIDENT
Credential: OT/L
Phone: 575-644-2214