MICHAEL DEAN CLARK

RACINE, WI
NPI1033108014
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: WI  420-023)
Enumeration Date2005-10-21
Last Update Date2013-05-07
Business Address
-- MICHAEL DEAN CLARK PA-C
3805B SPRING ST
RACINE, WI 53405-1641
Phone number: 262-687-4201
Mailing Address
-- MICHAEL DEAN CLARK PA-C
2629 FOX RIVER PKWY
WAUKESHA, WI 53189-7876
Phone number: 262-521-1674
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