Michael Clark
NPI 1063683597 · on the registry since 2008 · sole proprietor
Practice
- Address
- 619 Clarence St Apt 5
Lake Charles, LA 70601 - Phone
- (337) 721-8070
- Fax
- (337) 721-8060
Registry record
- Primary taxonomy
- Driver
172A00000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2008-03-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana