Organization
STACEY J. CLARKE D.P.M., P.C.
Active
Organization
STACEY J. CLARKE D.P.M., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY J CLARKE DPM (OWNER)
(541) 963-0265
Entity
Organization
Contact information
Practice address
1408 N HALL ST, LA GRANDE, OR 97850-3807
(541) 963-0265
(541) 963-6176
Mailing address
1408 N HALL ST, LA GRANDE, OR 97850-3807
(541) 963-0265
(541) 963-6176
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DP00283
OR
Other
Enumeration date
02/27/2007
Last updated
03/10/2015
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