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1962773648
CLARK CARROLL
JANESVILLE, WI
NPI
1962773648
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Other Name
CLARK T. CARROLL
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WI 7914)
Enumeration Date
2012-01-26
Last Update Date
2021-03-01
Business Address
CLARK CARROLL APNP
1820 CENTER AVE STE 170
JANESVILLE, WI 53546-2878
Phone number: 608-755-1475
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Mailing Address
CLARK CARROLL APNP
203 W SUNNY LN
JANESVILLE, WI 53546-9091
Phone number: 608-755-1475
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