Organization
CLERK SURGICAL ASSISTING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER L CLERK CFA (PRESIDENT)
(770) 254-1503
Entity
Organization
Contact information
Practice address
20 OZMORE ST, NEWNAN, GA 30263-1038
(770) 254-1503
Mailing address
20 OZMORE ST, NEWNAN, GA 30263-1038
(770) 254-1503
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/13/2007
Last updated
08/22/2020
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