Individual
MR. WILLIAM DOUGLAS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1617 HIGHWAY 20 W, MCDONOUGH, GA 30253-7311
(770) 961-1947
(770) 961-1947
Mailing address
PO BOX 254, MORROW, GA 30260-0254
(770) 961-1947
(770) 961-1947
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
—
—
Other
Enumeration date
11/21/2012
Last updated
11/21/2012
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