Individual
MARSHALL ANDRE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4501 SAND CREEK RD, ANTIOCH, CA 94531-8687
(925) 813-6716
Mailing address
2112 VICKSBURG AVE, OAKLAND, CA 94601-5420
(925) 948-6716
Taxonomy
Speciality
Code
Description
License number
State
2278C0205X
Critical Care Certified Respiratory Therapist
Primary
17366
CA
Other
Enumeration date
01/21/2019
Last updated
01/21/2019
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