Individual
MR. MATTHEW KLECAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.A.
Contact information
Practice address
5601 DOMINGO RD NE, ALBUQUERQUE, NM 87108-1610
(505) 268-5295
Mailing address
PO BOX 80982, ALBUQUERQUE, NM 87198-0982
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
105341
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B9311
—
NM
Enumeration date
06/21/2011
Last updated
06/21/2011
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