Individual
DR. CHESTER IRVIN CLARK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
157 UPLAND AVE, APT. A, HORSHAM, PA 19044-2616
(423) 967-9416
Mailing address
157 UPLAND AVE, APT. A, HORSHAM, PA 19044-2616
(423) 967-9416
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MT200648
PA
Other
Enumeration date
07/13/2011
Last updated
07/13/2011
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