MICHAEL DWAYNE CLARK

LAKE CHARLES, LA
NPI1063683597
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy172A00000X Driver
(Licence: LA  005916431)
Enumeration Date2008-03-12
Last Update Date2008-03-12
Business Address
Mr. MICHAEL DWAYNE CLARK
619 CLARENCE ST APT 5
LAKE CHARLES, LA 70601-5370
Phone number: 337-721-8070
Mailing Address
Mr. MICHAEL DWAYNE CLARK
619 CLARENCE ST APT 5
LAKE CHARLES, LA 70601-5370
Phone number: 337-721-8070
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