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1457659773
MICHAEL A CLARK
AUSTELL, GA
NPI
1457659773
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 6072)
Enumeration Date
2011-03-10
Last Update Date
2022-09-21
Business Address
MICHAEL A CLARK PA
3950 AUSTELL RD
AUSTELL, GA 30106-1121
Phone number: 770-732-5000
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Mailing Address
MICHAEL A CLARK PA
5665 NEW NORTHSIDE DR NW SUITE 320
ATLANTA, GA 30328-5831
Phone number: 770-874-5468
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