Individual
GREGORY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
59 TOWNSHIP ROAD 1419 # 2, PROCTORVILLE, OH 45669-8816
(681) 888-1003
Mailing address
59 TOWNSHIP ROAD 1419 # 2, PROCTORVILLE, OH 45669-8816
(681) 888-1003
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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