Mr. Derek Clark, BOCOCPED
Mr. Derek Clark, BOCOCPED is an Orthotist in Albuquerque, New Mexico. Licensed in Maryland. Registered with an NPI since 2014.
- Licensed in
- MD
- In the registry since
- 2014
Practice location Address checks out
5111 Juan Tabo Blvd NE Ste AAlbuquerque, NM 87111
Phone: (505) 200-9004
Fax: (505) 271-0217
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Orthotist (primary) | Taxonomy 222Z00000X · Licence C49914 (MD) |
|---|
Record details
| NPI number | 1497161590 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | BOCOCPED |
| Sole proprietor | No |
| NPI enumerated | July 9, 2014 |
| Last updated in NPPES | July 9, 2014 |
| Mailing address | 5111 Juan Tabo Blvd Ne, Ste A, Albuquerque, NM 87111 |