Individual
MR. KEVIN ALLEN TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
10501 LAGRIMA DE ORO RD NE, ALBUQUERQUE, NM 87111-3737
(505) 296-6700
Mailing address
1532 SAN LORENZO PL NW, ALBUQUERQUE, NM 87107-3411
(505) 340-5815
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4280
NM
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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