Individual
MR. WILLIAM R CLARK I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
17273 STATE ROUTE 104, CHILLICOTHE, OH 45601-9718
(740) 773-1141
Mailing address
17273 STATE ROUTE 207, CHILLICOTHE, OH 45601
(937) 305-9494
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
RN521227
OH
164W00000X
Licensed Practical Nurse
112658
OK
Other
Enumeration date
09/14/2009
Last updated
08/26/2024
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