Individual
ADAM J CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
162 HOLLYWOOD AVE, YOUNGSTOWN, OH 44512
(330) 770-9792
Mailing address
162 HOLLYWOOD AVE, YOUNGSTOWN, OH 44512
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7803355
—
OH
Enumeration date
11/16/2020
Last updated
11/16/2020
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