Individual
DARRON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1875 19TH ST NW, ROCHESTER, MN 55901-1633
(507) 282-9449
Mailing address
236 7TH ST NW, ROCHESTER, MN 55901-6815
(507) 513-3385
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A2039
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A2039
PTA LICENSE NUMBER
MN
Enumeration date
08/03/2021
Last updated
08/03/2021
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