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Individual

JULIAN CISNEROS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
5801 EUBANK BLVD NE APT 9, ALBUQUERQUE, NM 87111-6180
(757) 773-2922
Mailing address
5801 EUBANK BLVD NE APT 9, ALBUQUERQUE, NM 87111-6180
(757) 773-2922

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3889
NM

Other

Enumeration date
06/20/2018
Last updated
06/20/2018
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