Individual
FRANK M. GUSTAMANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
304 N RICHARDSON AVE, ROSWELL, NM 88201-4639
(575) 578-0069
(575) 578-0124
Mailing address
304 N RICHARDSON AVE, ROSWELL, NM 88201-4639
(575) 578-0069
(575) 578-0124
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2126
NM
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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