Organization
MK THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA JILL MICK OTR/L (OWNER)
(505) 681-0519
Entity
Organization
Contact information
Practice address
1448 MONTERREY RD NE, RIO RANCHO, NM 87144-1573
(505) 681-0519
Mailing address
1448 MONTERREY RD NE, RIO RANCHO, NM 87144-1573
(505) 681-0519
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1421
NM
Other
Enumeration date
03/20/2012
Last updated
03/21/2012
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