Individual
JON ALBERT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
22193
SC
367500000X
Certified Registered Nurse Anesthetist
4704263474
MI
Other
Enumeration date
06/08/2006
Last updated
01/03/2022
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