Individual
MR. COLIE BOB CLARK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS, CCP, LP
Contact information
Practice address
3101 CARRIAGE TRL, HILLSBOROUGH, NC 27278-8508
(919) 880-3688
Mailing address
3101 CARRIAGE TRL, HILLSBOROUGH, NC 27278-8508
(919) 880-3688
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
NC
Other
Enumeration date
03/25/2008
Last updated
03/25/2008
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