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1760142038
OMAR VILLA
GALLUP, NM
NPI
1760142038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: NM OTA4506)
Enumeration Date
2021-12-28
Last Update Date
2021-12-28
Business Address
OMAR VILLA COTA
224 E NIZHONI BLVD
GALLUP, NM 87301-5744
Phone number: 505-863-9551
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Mailing Address
OMAR VILLA COTA
224 E NIZHONI BLVD
GALLUP, NM 87301-5744
Phone number:
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