Individual
PATRICK O OBERMULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4101 MOUNTAIN TRAIL LOOP NE, RIO RANCHO, NM 87144-7012
(575) 415-8575
Mailing address
PO BOX 44971, RIO RANCHO, NM 87174-4971
(575) 415-8575
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAD0200771
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16062019
—
NM
Enumeration date
09/12/2019
Last updated
09/12/2019
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