Healthcare Provider Details

I. General information

NPI: 1346597309
Provider Name (Legal Business Name): CHRISTINA MONTES DE OCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 08/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 1/2 E SAN FRANCISCO ST
SANTA FE NM
87501-2167
US

IV. Provider business mailing address

1613 CALLE TORREON
SANTA FE NM
87501-1714
US

V. Phone/Fax

Practice location:
  • Phone: 505-986-9939
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number0867
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: