DEREK CLARK, BOCO C.PED, Orthotist ALBUQUERQUE, NM

Contact Information

DEREK CLARK, BOCO C.PED

5111 JUAN TABO BLVD NE
STE A
ALBUQUERQUE, NM 87111

Phone: 505-200-9004
Fax: 505-271-0217
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Orthotist	222Z00000X	55	Individual Certified Orthotist

Indicates primary specialty

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NPI Profile & details for DEREK CLARK · (Male)

NPI Number	`1497161590`
Status	Active
Credentials	BOCO C.PED
Entity	Individual
Enumeration date	07/09/2014
Last updated	07/09/2014 - About 12 years ago
Sole proprietor ¹	No
Identifiers	MD License # C49914
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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DEREK CLARK, BOCO C.PED – NPI #1497161590Orthotist

Contact Information

Specialty

Orthotist

NPI Profile & details for DEREK CLARK · (Male)

Reviews for DEREK CLARK

DEREK CLARK, BOCO C.PED – NPI #1497161590
Orthotist