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1003386657
DMITRIUS CLARK
STOCKTON, CA
NPI
1003386657
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2018-11-27
Last Update Date
2018-11-27
Business Address
DMITRIUS CLARK
3620 W. HAMMER LANE
STOCKTON, CA 95219
Phone number: 209-521-4791
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Mailing Address
DMITRIUS CLARK
3425 COFFEE RD SUITE C2
MODESTO, CA 95355
Phone number:
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