Individual
MICHAEL JOSEPH AMUNDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
50 CHAMISA ROAD., MIMBRES, NM 88049-0078
(575) 536-2958
(575) 536-2958
Mailing address
PO BOX 78, MIMBRES, NM 88049-0078
(575) 536-2958
(575) 536-2958
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
211132
TX
224Z00000X
Occupational Therapy Assistant
Primary
2773
NM
Other
Enumeration date
04/17/2014
Last updated
04/17/2014
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