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Individual

KEVIN DEWITT CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
AP

Contact information

Practice address
130 N DIXIE HWY, HOLLYWOOD, FL 33020-6704
(954) 719-4078
(186) 661-0623
Mailing address
130 N DIXIE HWY, HOLLYWOOD, FL 33020-6704
(954) 719-4078
(186) 661-0623

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP424
FL

Other

Enumeration date
10/17/2008
Last updated
10/17/2008
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