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General NPI Number Information
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NPI Number | 1477669638
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Entity Type | Organization
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Legal Business Name | ROSWELL HAND CLINIC & OCCUPATIONAL THERAPY CENTER INC
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 110 W COUNTRY CLUB RD
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City | ROSWELL
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State | NM
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Zip | 88201
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Country | US
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Telephone | 505-623-2292
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Fax | 505-623-2255
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Provider Business Mailing Address
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Address Line | 110 W COUNTRY CLUB RD
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City | ROSWELL
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State | NM
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Zip | 88201
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Country | US
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Telephone | 505-623-2292
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Fax | 505-623-2255
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MRS. CYNTHIA J SERRANO
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Credential | OTR/L, CHT, ASHT
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Telephone | 575-623-2292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 295
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License Number State | NM
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