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Individual

MR. BRANT A BERMUDEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L,CHT

Contact information

Practice address
8220 LOUISIANA BLVD NE, SUITE D, ALBUQUERQUE, NM 87113-2105
(505) 724-4300
(505) 724-4384
Mailing address
201 CEDAR ST SE, SUITE 6600, ALBUQUERQUE, NM 87106-4915
(505) 724-4300
(505) 724-4384

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2411
NM
225XH1200X
Hand Occupational Therapist
2597
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
71781722
NM
05
889884
AZ
Enumeration date
10/11/2005
Last updated
04/29/2013
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