Individual
MARK CLEMENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 STATE ST, ERIE, PA 16501-1106
(814) 453-6791
Mailing address
405 STATE ST, ERIE, PA 16501-1106
(814) 453-6791
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
PA
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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