Healthcare Provider Details

I. General information

NPI: 1912267493
Provider Name (Legal Business Name): OCCUPATIONAL TESTING RESOURCES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1504 N. GRIMES
HOBBS NM
88240
US

IV. Provider business mailing address

PMB 175 4008 N. GIMES
HOBBS NM
88240
US

V. Phone/Fax

Practice location:
  • Phone: 575-397-0387
  • Fax: 575-397-0388
Mailing address:
  • Phone: 575-397-0387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. RACHEL CARMONA
Title or Position: OWNER/MANAGER
Credential:
Phone: 575-397-0387