Individual
JONATHAN CAMPOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 LOMAS BLVD NW, ALBUQUERQUE, NM 87102-2080
(505) 247-1701
Mailing address
1321 E POPLAR ST, DEMING, NM 88030-4807
(575) 546-5951
(575) 546-5994
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
40355
NM
Other
Enumeration date
07/26/2019
Last updated
07/26/2019
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