Individual
BENJAMIN D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4225 E CHURCH ST, FARMVILLE, NC 27828-1690
(252) 717-4090
Mailing address
4225 E CHURCH ST, FARMVILLE, NC 27828-1690
(252) 717-4090
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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