Individual
CORY MICHAEL PRACHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
28 ESCONDIDA LN, SOCORRO, NM 87801-5406
(575) 418-9328
Mailing address
28 ESCONDIDA LN, SOCORRO, NM 87801-5406
(575) 418-9328
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3408
NM
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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