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Individual

RYAN JAMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
119 LUNA ST SE, LOS LUNAS, NM 87031-6814
(505) 866-8241
Mailing address
2300 DIAMOND MESA TRL SW APT 3706, ALBUQUERQUE, NM 87121-3726
(770) 841-2985

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3671
NM

Other

Enumeration date
02/22/2017
Last updated
02/22/2017
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