Individual
LUIS REY LEYVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1107 SOUTH 11TH ST, TUCUMCARI, NM 88401
(505) 461-4344
(505) 461-8033
Mailing address
6314 QUAY ROAD AJ, TUCUMCARI, NM 88401-9728
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1989
NM
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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