Individual
MR. LARIN TIMOTHY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDMT, LPN
Contact information
Practice address
243 CURTISS RD STE 100, BARKSDALE AFB, LA 71110-2425
(318) 456-6555
Mailing address
243 CURTISS RD STE 100, BARKSDALE AFB, LA 71110-2425
(318) 456-6555
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
0002105974
LA
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
04/05/2019
Last updated
11/07/2025
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