Individual
ELIAS GERRIT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
531 COUNTRY HILL CT NE, APARTMENT 2, CEDAR RAPIDS, IA 52402-8310
(605) 929-9380
Mailing address
531 COUNTRY HILL CT NE, APARTMENT 2, CEDAR RAPIDS, IA 52402-8310
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
240891
IA
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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