Individual
MR. JONATHAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
206 FINLEY FOREST DR, CHAPEL HILL, NC 27517-8689
(910) 364-8611
Mailing address
206 FINLEY FOREST DR, CHAPEL HILL, NC 27517-8689
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/30/2012
Last updated
10/30/2012
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