Individual
MR. KENNETH M CLARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
Mailing address
1800 VASSAR DR SE, ALBUQUERQUE, NM 87106-3127
(505) 843-8300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA83015
NM
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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