# CLARK CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013540947
- **Authorized official:** LOWELL F. CLARK (OWNER)
- **Authorized official phone:** (352) 793-2441

## Contact information

- **Practice address:** 12620 CURLEY ST, SAN ANTONIO, FL 33576-8136
- **Practice address phone:** (352) 787-1600
- **Mailing address:** 212 S FLORIDA ST, BUSHNELL, FL 33513-6703
- **Mailing address phone:** (352) 793-2441

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/19/2020
- **Last updated:** 02/19/2020