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Individual

GEORGE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
P13 AVON DR, EAST WINDSOR NJ, NJ 08520
(919) 632-4347
Mailing address
P13 AVON DR, EAST WINDSOR, NJ 08520-5653
(910) 977-0539

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
40QB00319500
NJ

Other

Enumeration date
07/29/2015
Last updated
07/29/2015
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