PHILLIP DOUGLAS CLARK

LONGS, SC
NPI1053912451
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy374U00000X Home Health Aide
(Licence: SC  1264)
Additional Taxonomies374U00000X Home Health Aide
(Licence:   1264)
Enumeration Date2020-11-03
Last Update Date2020-11-03
Business Address
Mr. PHILLIP DOUGLAS CLARK
2126 HIGHWAY 9 E UNIT 5B
LONGS, SC 29568-5725
Phone number: 843-353-8664
Mailing Address
Mr. PHILLIP DOUGLAS CLARK
3988 TYBRE CT
LITTLE RIVER, SC 29566-8483
Phone number: 843-353-8664