LARRY DALE CLARK

ROSEBURG, OR
NPI1144849589
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2020-04-15
Last Update Date2020-04-15
Business Address
LARRY DALE CLARK
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-440-3532
Mailing Address
LARRY DALE CLARK
621 W MADRONE ST
ROSEBURG, OR 97470-3090
Phone number: 541-440-3532
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