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1760247811
JAE H CLARK
PHILADELPHIA, PA
NPI
1760247811
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: PA RT005767)
Enumeration Date
2024-02-19
Last Update Date
2024-02-19
Business Address
JAE H CLARK ATC, LAT
1651 BENJAMIN FRANKLIN PKWY
PHILADELPHIA, PA 19103-1284
Phone number: 215-303-4818
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Mailing Address
JAE H CLARK ATC, LAT
2230 GRAHAM ST
PHILADELPHIA, PA 19131-2203
Phone number: 215-303-4818
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