Individual
MR. JEFF RICHARD BAZANELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547-2575
(505) 944-7224
(505) 944-7229
Mailing address
1101 LOPEZ ROAD SW, ALBUQUERQUE, NM 87105
(505) 877-7060
(505) 877-7063
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6969
CO
Other
Enumeration date
05/29/2015
Last updated
10/29/2023
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