Individual
DR. MICHAEL E CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, PAIN PROGRAM (2CW), TAMPA, FL 33612-4745
(813) 972-2000
(813) 978-5867
Mailing address
13000 BRUCE B DOWNS BLVD, PAIN PROGRAM (2CW), TAMPA, FL 33612-4745
(813) 972-2000
(813) 978-5867
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
PY3564
FL
Other
Enumeration date
02/06/2006
Last updated
07/12/2007
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