BENJAMIN CLARK

PORTLAND, OR
NPI1770871113
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
Additional Taxonomies222Z00000X Orthotist
Enumeration Date2011-07-19
Last Update Date2018-03-01
Business Address
BENJAMIN CLARK CPO
17316 NE HALSEY ST
PORTLAND, OR 97230-6026
Phone number: 503-257-6623
Mailing Address
BENJAMIN CLARK CPO
17316 NE HALSEY ST
PORTLAND, OR 97230-6026
Phone number: 503-257-6623
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