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1437210630
STEPHEN W. CLARK
SHREVEPORT, LA
NPI
1437210630
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA AP01372)
Enumeration Date
2006-12-12
Last Update Date
2007-07-08
Business Address
Mr. STEPHEN W. CLARK CRNA
1130 LOUISIANA AVE
SHREVEPORT, LA 71101-3908
Phone number: 678-227-1211
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Mailing Address
Mr. STEPHEN W. CLARK CRNA
4950 OAK POINT DR
SHREVEPORT, LA 71107-7409
Phone number: 318-227-1211
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