Individual
MRS. MOLLIE R STUCHLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
900 SOUTH 12TH STREET, ROCKY FORD, CO 81067
(719) 254-4202
(719) 254-4202
Mailing address
321 LOG AVENUE, LA JUNTA, CO 81050
(719) 384-0381
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1007653
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72489731
—
CO
Enumeration date
11/22/2006
Last updated
07/08/2007
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