JAIME CLARK

SUMMERVILLE, SC
NPI1952178303
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: NC  0010-14109)
Enumeration Date2023-12-06
Last Update Date2025-09-08
Business Address
-- JAIME CLARK
112 MIKEL CT
SUMMERVILLE, SC 29485-4806
Phone number: 774-313-0827
Mailing Address
-- JAIME CLARK
112 MIKEL CT
SUMMERVILLE, SC 29485-4806
Phone number: