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Organization
JASON H CLARK & SANDRA J CLARK
Active
Organization
JASON H CLARK & SANDRA J CLARK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON CLARK (OWNER)
(662) 514-5215
Entity
Organization
Contact information
Practice address
139 COUNTY ROAD 379, WATER VALLEY, MS 38965-3607
(662) 514-5215
(662) 234-0172
Mailing address
PO BOX 994, OXFORD, MS 38655-0994
(662) 514-5215
(662) 234-0172
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
MRT2279
MS
Other
Enumeration date
02/01/2008
Last updated
12/03/2008
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