Individual
SHANE BRATCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5840 FORTUNA DR, FARMINGTON, NM 87402-8210
(505) 599-8625
Mailing address
5840 FORTUNA DR, FARMINGTON, NM 87402-8210
(505) 599-8625
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
CF6493
NM
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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