Individual
GERARD CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 S 69TH ST, UPPER DARBY, PA 19082-4212
(610) 352-8943
(610) 352-8880
Mailing address
569 PARKER AVE, PHILADELPHIA, PA 19128-2423
(215) 509-6634
(610) 352-8880
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW-002765-E
PA
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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