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1356907083
GUY MAX CLARK
GALLUP, NM
NPI
1356907083
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163WM0705X Registered Nurse Medical-Surgical
(Licence: TX 897468)
Enumeration Date
2019-05-17
Last Update Date
2019-05-17
Business Address
GUY MAX CLARK RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
GUY MAX CLARK RN
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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