KYLE R CLARK

ROCKFORD, IL
NPI1801415864
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085.007488)
Enumeration Date2020-04-10
Last Update Date2020-04-10
Business Address
KYLE R CLARK PA-C
5666 E STATE ST
ROCKFORD, IL 61108-2425
Phone number: 815-226-2000
Mailing Address
KYLE R CLARK PA-C
1395 JAY ST
FREEPORT, IL 61032-8424
Phone number: 815-291-4052
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