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1174534085
CASEY RYAN CLARK
ATHENS, AL
NPI
1174534085
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1-104686)
Enumeration Date
2006-08-10
Last Update Date
2007-07-08
Business Address
Mr. CASEY RYAN CLARK CRNA
22234 KENNEMER LN
ATHENS, AL 35613-8162
Phone number: 256-206-2081
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Mailing Address
Mr. CASEY RYAN CLARK CRNA
22234 KENNEMER LN
ATHENS, AL 35613-8162
Phone number: 256-206-2081
Copy
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