Provider Demographics
NPI:1912267493
Name:OCCUPATIONAL TESTING RESOURCES LLC
Entity type:Organization
Organization Name:OCCUPATIONAL TESTING RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:575-397-0387
Mailing Address - Street 1:PMB 175
Mailing Address - Street 2:4008 N. GIMES
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240
Mailing Address - Country:US
Mailing Address - Phone:575-397-0387
Mailing Address - Fax:
Practice Address - Street 1:1504 N. GRIMES
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240
Practice Address - Country:US
Practice Address - Phone:575-397-0387
Practice Address - Fax:575-397-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care