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1790454726
KEVIN CLARK
BOSTON, MA
NPI
1790454726
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2021-09-13
Last Update Date
2021-10-12
Business Address
KEVIN CLARK PA-C
55 FRUIT ST
BOSTON, MA 02114-2696
Phone number: 617-724-4100
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Mailing Address
KEVIN CLARK PA-C
1675 WASHINGTON ST APT 1
BOSTON, MA 02118-3485
Phone number: 518-209-6575
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