Individual
JUSTIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
362 BEAL PKWY NW STE 105, FORT WALTON BEACH, FL 32548-3926
(850) 862-3020
(850) 862-1363
Mailing address
362 BEAL PKWY NW STE 105, FORT WALTON BEACH, FL 32548-3926
(850) 862-3020
(850) 862-1363
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
OS9224
FL
Other
Enumeration date
03/27/2006
Last updated
03/17/2018
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