Individual
MICHAEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19 SECOND AVE, AUBURN, NY 13021-5113
(315) 246-5078
Mailing address
19 SECOND AVE, AUBURN, NY 13021-5113
(315) 246-5078
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/14/2017
Last updated
02/14/2017
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