Individual
GREGORY W CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 KNOWLSON AVE, BEAVER FALLS, PA 15010-1634
(724) 891-2100
(724) 891-2735
Mailing address
100 KNOWLSON AVE, BEAVER FALLS, PA 15010-1634
(724) 891-2100
(724) 891-2735
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN550651
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550651
RN LICENSE
PA
Enumeration date
09/02/2009
Last updated
12/10/2010
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