Individual
JOSE JAIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 N NORRIS ST, CLOVIS, NM 88101-6371
(575) 762-3753
Mailing address
1201 N NORRIS ST, CLOVIS, NM 88101-6371
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1600
NM
Other
Enumeration date
12/27/2014
Last updated
12/27/2014
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