Individual
ISAIAH JORDAN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 INDIAN RIVER RD, SITKA, AK 99835-7480
(907) 747-3636
Mailing address
701 INDIAN RIVER RD, SITKA, AK 99835-7480
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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