Individual
ANTHONY JAMAL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2301 MONTGOMERY DR W, WILSON, NC 27893-4476
(252) 360-9338
Mailing address
3011 NC HIGHWAY 42 W STE C, WILSON, NC 27893-7735
(919) 413-8449
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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