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1497161590
DEREK CLARK
ALBUQUERQUE, NM
NPI
1497161590
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
222Z00000X Orthotist
(Licence: MD C49914)
Enumeration Date
2014-07-09
Last Update Date
2014-07-09
Business Address
Mr. DEREK CLARK BOCO C.ped
5111 JUAN TABO BLVD NE STE A
ALBUQUERQUE, NM 87111
Phone number: 505-200-9004
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Mailing Address
Mr. DEREK CLARK BOCO C.ped
5111 JUAN TABO BLVD NE STE A
ALBUQUERQUE, NM 87111
Phone number: 505-200-9004
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