Individual
CHARLES WILLIAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4175 CHESTERLAND BLVD, STOW, OH 44224-1820
(330) 603-4559
Mailing address
4175 CHESTERLAND BLVD, STOW, OH 44224-1820
(330) 603-4559
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
406677
OH
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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