Individual
ELLIOTT CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
515 UNION AVE STE 167, DOVER, OH 44622-3005
(330) 343-3335
(330) 364-5720
Mailing address
524 PARK AVE SW, BOLIVAR, OH 44612-9534
(860) 933-8265
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50.005394RX
OH
Other
Enumeration date
01/16/2018
Last updated
03/16/2026
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