Individual
KENNETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
724 N CHARLOTTE ST, POTTSTOWN, PA 19464-4607
(610) 323-1837
Mailing address
300 MASTERS DRIVE, POTTSTOWN, PA 19464
(484) 250-3932
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN664213
PA
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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