Individual
JARETTA BURK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2002 SUDDERTH DR, RUIDOSO, NM 88345-6119
(575) 257-2368
(575) 257-2141
Mailing address
2002 SUDDERTH DR, RUIDOSO, NM 88345-6119
(575) 257-2368
(575) 257-2141
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3682
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
850441031
—
NM
Enumeration date
12/19/2013
Last updated
09/14/2023
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