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Individual
DANIEL LEE CLARK
Active
Individual
DANIEL LEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
CR2016-000553
TX
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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