Individual
MR. LESTER JUNIOR CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2735 11TH ST W, WEST FARGO, ND 58078-2470
(701) 412-1030
Mailing address
2735 11TH ST W, WEST FARGO, ND 58078-2470
(701) 412-1030
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
R49149
ND
Other
Enumeration date
04/22/2022
Last updated
04/22/2022
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