JONATHAN CLARK

DECATUR, GA
NPI1720573447
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA  AT003189)
Enumeration Date2018-06-25
Last Update Date2018-06-25
Business Address
JONATHAN CLARK
1214 HIGHLAND LAKE CIR
DECATUR, GA 30033-3460
Phone number: 585-857-2586
Mailing Address
JONATHAN CLARK
1214 HIGHLAND LAKE CIR
DECATUR, GA 30033-3460
Phone number: