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1114346434
CHARLES CLARK
NAMPA, ID
NPI
1114346434
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: ID M-15579)
Enumeration Date
2014-04-15
Last Update Date
2021-01-13
Business Address
CHARLES CLARK MD
9850 W ST LUKES DR
NAMPA, ID 83687-7912
Phone number: 208-706-2663
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Mailing Address
CHARLES CLARK MD
2718 W JETTON AVE
TAMPA, FL 33629-5327
Phone number: 813-784-0002
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