Organization
CLARK BUILDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL L CLARK CONTRACTOR (OWNER)
(731) 988-5304
Entity
Organization
Contact information
Practice address
860 BEAR CREEK RD, PINSON, TN 38366-1955
(731) 988-5304
(731) 425-2485
Mailing address
860 BEAR CREEK RD, PINSON, TN 38366-1955
(731) 988-5304
(731) 425-2485
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
Primary
00054804
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00054804
STATE OF TENNESSEE CONTRACTOR
TN
01
—
039920964
TENNESSEE DRIVERS LICENSE
TN
Enumeration date
03/13/2014
Last updated
03/13/2014
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