MEDICARE: DR. ELAINE J STRUTHERS PH.D., OTR,L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	2355	NM

General Provider Information

NPI Number	:	1982755658
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE J STRUTHERS PH.D., OTR,L

Provider Business Mailing Address
First Line	:	205 W BOUTZ RD
Second Line	:	BLDG 1
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3259
Country	:	US
Telephone Number	:	575-532-7000
Fax Number	:	575-532-7006

Provider Business Practice Location Address
First Line	:	1744 S TRIVIZ DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5103
Country	:	US
Telephone Number	:	360-296-8242
Fax Number	:	575-532-7006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	06/21/2010

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