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1790414290
GREGG PHILLIP CLARK
LOUISA, KY
NPI
1790414290
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2022-06-09
Last Update Date
2022-06-09
Business Address
GREGG PHILLIP CLARK PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-639-0938
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Mailing Address
GREGG PHILLIP CLARK PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1065
Phone number: 606-639-0938
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