Individual
MR. DARYL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13 SURREY CT STE 200, COLUMBIA, SC 29212-3172
(803) 553-5965
(803) 451-0328
Mailing address
13 SURREY CT STE 200, COLUMBIA, SC 29212-3172
(803) 553-5965
(803) 451-0328
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
SC
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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