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1356365316
JAMES A CLARK
FORT ATKINSON, WI
NPI
1356365316
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 484)
Enumeration Date
2006-07-26
Last Update Date
2007-07-08
Business Address
-- JAMES A CLARK CADCIII
509 MCMILLEN ST
FORT ATKINSON, WI 53538-1263
Phone number: 920-563-7995
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Mailing Address
-- JAMES A CLARK CADCIII
509 MCMILLEN ST
FORT ATKINSON, WI 53538-1263
Phone number: 920-563-7995
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