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1245284629
MATTHEW WILLIAM CLARK
FPO, AA
NPI
1245284629
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2006-05-20
Last Update Date
2010-05-12
Business Address
Mr. MATTHEW WILLIAM CLARK IDC
USS PHILIPPINE SEA
FPO, AA 34092-1178
Phone number: 904-270-6502
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Mailing Address
Mr. MATTHEW WILLIAM CLARK IDC
453 CODY DR
ORANGE PARK, FL 32073-4214
Phone number: 904-270-5936
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