KENNETH D ROARK

ALBUQUERQUE, NM
NPI1518019447
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: NM  97-PA20)
Enumeration Date2007-01-18
Last Update Date2008-08-14
Business Address
KENNETH D ROARK PA-C
PMG URGENT CARE 5901 HARPER DRIVE NE
ALBUQUERQUE, NM 87109
Phone number: 505-823-8519
Mailing Address
KENNETH D ROARK PA-C
PO BOX 26666 PHS PROVIDER ENROLLMENT
ALBUQUERQUE, NM 87125-6666
Phone number: 505-923-5356
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