Individual
MARIO GARDEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
755 S TELSHOR BLVD STE 201A, LAS CRUCES, NM 88011-8680
(575) 556-2103
Mailing address
755 S TELSHOR BLVD STE 201A, LAS CRUCES, NM 88011-8680
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3090
NM
Other
Enumeration date
01/20/2014
Last updated
01/20/2014
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