Individual
CLARK L CARROL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
BOX 1020665, SIOUX FALLS, SD 57186-0001
(415) 632-3166
Mailing address
BOX 1020665, SIOUX FALLS, SD 57186-0001
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C40567
CA
Other
Enumeration date
10/18/2007
Last updated
06/30/2009
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