Individual
MRS. DACY JAEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
6100 SEAGULL ST NE STE 102, ALBUQUERQUE, NM 87109-2500
(505) 823-2411
(505) 858-0650
Mailing address
6100 SEAGULL ST NE STE 102, ALBUQUERQUE, NM 87109-2500
(505) 823-2411
(505) 858-0650
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4693
NM
Other
Enumeration date
04/25/2016
Last updated
05/24/2016
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