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1780913640
CHARLES S CLARK
JACKSONVILLE, FL
NPI
1780913640
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
Enumeration Date
2009-12-23
Last Update Date
2009-12-23
Business Address
-- CHARLES S CLARK
BLDG. H 2005 KNIGHT LANE ATTN: MEDICAL STAFF SERVICES NAVY MEDICINE SUPPORT COMMAND
JACKSONVILLE, FL 92055-0140
Phone number: 858-361-9254
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Mailing Address
-- CHARLES S CLARK
3986 SHIELDS ST
SAN DIEGO, CA 92124-3314
Phone number: 858-361-9254
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