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1164415204
JONATHAN CLARK
SPRINGFIELD, MO
NPI
1164415204
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MO MD101561)
Enumeration Date
2005-08-24
Last Update Date
2007-07-08
Business Address
-- JONATHAN CLARK
1200 E WOODHURST DR SUITE Q-200
SPRINGFIELD, MO 65804-4257
Phone number: 417-881-5639
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Mailing Address
-- JONATHAN CLARK
1200 E WOODHURST DR SUITE Q-200
SPRINGFIELD, MO 65804-4257
Phone number:
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