Individual
MR. JOSE ROBERTO CORREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-A
Contact information
Practice address
2060 MAIN ST NE STE A, LOS LUNAS, NM 87031-6368
(505) 247-4466
Mailing address
2060 MAIN ST NE STE C, LOS LUNAS, NM 87031-6368
(505) 916-5977
(505) 916-5976
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2840
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23028319
—
NM
Enumeration date
11/29/2005
Last updated
08/31/2022
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