JACK PROW CLARK

SYRACUSE, IN
NPI1346320140
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  01017687)
Enumeration Date2006-10-16
Last Update Date2007-07-08
Business Address
Dr. JACK PROW CLARK M.D.
518 EMS D15 LN
SYRACUSE, IN 46567-8026
Phone number: 574-457-3292
Mailing Address
Dr. JACK PROW CLARK M.D.
518 EMS D15 LN
SYRACUSE, IN 46567-8026
Phone number: 574-457-3292
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