Individual
JERRY KENT CLARK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4611 OTTER CT, BURLINGTON, NC 27215-9076
(336) 263-0330
Mailing address
4611 OTTER CT, BURLINGTON, NC 27215-9076
(336) 263-0330
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
6075
NC
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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