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Individual

WILLIAM CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1042 WILLOW CREEK RD, PRESCOTT, AZ 86301-1673
(928) 379-0838
Mailing address
1042 WILLOW CREEK RD, PRESCOTT, AZ 86301-1673
(928) 379-0838

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9297
AZ

Other

Enumeration date
05/24/2022
Last updated
12/05/2023
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