Individual
MICHAEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8305 CONCORD DR, ROWLETT, TX 75089-2001
(214) 694-0822
Mailing address
8305 CONCORD DR, ROWLETT, TX 75089-2001
(214) 694-0822
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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