Individual
DR. JOHN GLENN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 WHISKEAG RD, BATH, ME 04530-4127
(909) 435-0066
Mailing address
111 WHISKEAG RD, BATH, ME 04530-4127
(909) 435-0066
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
016756
ME
207X00000X
Orthopaedic Surgery Physician
A60772
CA
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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