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Individual

JUSTIN BOOKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
806 W MAPLE ST, FARMINGTON, NM 87401-5631
(505) 325-2910
Mailing address
801 APACHE AVE, AZTEC, NM 87410-2210
(505) 402-5107

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3594
NM

Other

Enumeration date
01/09/2017
Last updated
01/09/2017
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