Individual
CLARK HARDGRAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5608 ZUNI RD SE, ALBUQUERQUE, NM 87108-2926
(505) 262-2481
(505) 262-0781
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2014-0067
NM
Other
Enumeration date
09/22/2014
Last updated
03/13/2025
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