LONNIE CLARK

ASHLAND, OR
NPI1134543226
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OR  13-12-10)
Enumeration Date2014-02-10
Last Update Date2014-02-10
Business Address
LONNIE CLARK CADC I
695 MISTLETOE RD STE H
ASHLAND, OR 97520-9552
Phone number: 541-482-8906
Mailing Address
LONNIE CLARK CADC I
201 W MAIN ST STE 3D
MEDFORD, OR 97501-2744
Phone number: 541-779-2393
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