Individual
MR. ANDREW THOMAS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017
(636) 735-4268
Mailing address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 735-4268
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2013001474
MO
Other
Enumeration date
10/17/2012
Last updated
05/14/2019
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