Individual
EVANS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
526 S SAN PEDRO ST, LOS ANGELES, CA 90013-2102
(213) 488-9559
Mailing address
10507 CRENSHAW BLVD, 1, INGLEWOOD, CA 90303-4483
(213) 488-9559
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/30/2010
Last updated
07/30/2010
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