Individual
DAVID RAY CLARK IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
109 6TH ST, SOUTH PITTSBURG, TN 37380-1331
(423) 838-2780
Mailing address
109 6TH ST, SOUTH PITTSBURG, TN 37380-1331
(423) 838-2780
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
71446
TN
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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