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Individual

MR. STEPHEN MARK CLARKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RD

Contact information

Practice address
28 DEHAVEN AVE, PENNDEL, PA 19047-5208
(215) 752-1802
(215) 752-1802
Mailing address
28 DEHAVEN AVE, PENNDEL, PA 19047-5208
(215) 752-1802
(215) 752-1802

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN000171
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001514652-0001
PA
Enumeration date
03/08/2008
Last updated
03/08/2008
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