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1730235904
GREGORY GLEN CLARK
MARIETTA, GA
NPI
1730235904
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 001772)
Enumeration Date
2007-01-28
Last Update Date
2022-07-14
Business Address
Mr. GREGORY GLEN CLARK P.A.
677 CHURCH ST NE
MARIETTA, GA 30060-1101
Phone number: 770-794-0477
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Mailing Address
Mr. GREGORY GLEN CLARK P.A.
531 ROSELANE ST NW STE 830
MARIETTA, GA 30060-6979
Phone number: 770-794-0477
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