RYAN WILLIAM CLARK

GREEN BAY, WI
NPI1720499759
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208VP0014X Pain Medicine, Interventional Pain Medicine
(Licence: WI  67188)
Additional Taxonomies208100000X Physical Medicine & Rehabilitation
(Licence: WI  67188)
208VP0000X Pain Medicine, Pain Medicine
(Licence: WI  67188)
Enumeration Date2014-05-13
Last Update Date2023-05-25
Business Address
RYAN WILLIAM CLARK D.O.
2845 GREENBRIER RD
GREEN BAY, WI 54311-6519
Phone number: 920-288-8377
Mailing Address
RYAN WILLIAM CLARK D.O.
PO BOX 28900
GREEN BAY, WI 54324-0900
Phone number: 920-288-8377