CHARLES CLARK

NAMPA, ID
NPI1114346434
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207X00000X Orthopaedic Surgery
(Licence: ID  M-15579)
Enumeration Date2014-04-15
Last Update Date2021-01-13
Business Address
CHARLES CLARK MD
9850 W ST LUKES DR
NAMPA, ID 83687-7912
Phone number: 208-706-2663
Mailing Address
CHARLES CLARK MD
2718 W JETTON AVE
TAMPA, FL 33629-5327
Phone number: 813-784-0002