Individual
CHRISTOPHER MARVIN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
700 PELHAM RD N, JACKSONVILLE, AL 36265-1602
(256) 782-5514
(256) 782-5546
Mailing address
1151 LAKE FOREST DR N, SOUTHSIDE, AL 35907-7111
(256) 613-2384
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
857
AL
Other
Enumeration date
10/25/2019
Last updated
10/25/2019
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