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1952040552
PORTER GRACE CLARK
PANAMA CITY, FL
NPI
1952040552
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2022-06-01
Last Update Date
2024-02-13
Business Address
PORTER GRACE CLARK PA-C
2306 MARTIN LUTHER KING JR BLVD
PANAMA CITY, FL 32405-4404
Phone number: 850-250-0021
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Mailing Address
PORTER GRACE CLARK PA-C
2306 MARTIN LUTHER KING JR BLVD
PANAMA CITY, FL 32405-4404
Phone number: 540-255-5501
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