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1427297811
DARRICK LAMONT CLARK
CANTON, GA
NPI
1427297811
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant Surgical
(Licence: GA 3053)
Enumeration Date
2009-02-09
Last Update Date
2017-02-07
Business Address
MR. DARRICK LAMONT CLARK PA
111 HOLLY MILL VILLAGE DR
CANTON, GA 30114-7175
Phone number: 678-787-8173
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Mailing Address
MR. DARRICK LAMONT CLARK PA
111 HOLLY MILL VILLAGE DR
CANTON, GA 30114-7175
Phone number: 678-787-8173
Copy
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