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1154984953
CLARK PEREZ
GALLUP, NM
NPI
1154984953
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: FL 9395615)
Enumeration Date
2019-04-17
Last Update Date
2019-04-17
Business Address
CLARK PEREZ RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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Mailing Address
CLARK PEREZ RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1790
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