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1801010012
RON WAYNE CLARK
SANTA CRUZ, CA
NPI
1801010012
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2007-04-12
Last Update Date
2007-07-08
Business Address
-- RON WAYNE CLARK
2422 ORIOLE LN
SANTA CRUZ, CA 95062-4262
Phone number: 831-818-8894
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Mailing Address
-- RON WAYNE CLARK
2422 ORIOLE LN
SANTA CRUZ, CA 95062-4262
Phone number: 818-818-8894
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