Individual
RAPHAEL JOSEPH CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1600 SUTTER PL, CLOVIS, NM 88101-4611
(505) 769-4490
(505) 935-0011
Mailing address
2005 RAINTREE, CLOVIS, NM 88101-9595
(505) 799-3469
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1018
NM
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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