# ASPIRE FAMILY MEDICINE &WELLNESS CENTER, LLC

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

## Provider details

- **NPI number:** 1821284407
- **Authorized official:** DR. MICHAEL A CLARK M.D (PHYSICIAN/OWNER)
- **Authorized official phone:** (203) 269-9778

## Contact information

- **Practice address:** 850 N MAIN STREET EXT, BLDG 2 SUITE C2, WALLINGFORD, CT 06492-2400
- **Practice address phone:** (203) 269-9778
- **Practice address fax:** (203) 949-1544
- **Mailing address:** 850 N MAIN STREET EXT, BLDG 2 SUITE C2, WALLINGFORD, CT 06492-2400
- **Mailing address phone:** (203) 269-9778
- **Mailing address fax:** (203) 949-1544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2007
- **Last updated:** 09/18/2007