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Individual

CHRISTOPHER S CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621
(617) 726-2000

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3873
MA

Other

Enumeration date
09/25/2009
Last updated
09/25/2009
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