Individual
ROBERT CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 N WILLARD ST, COTTONWOOD, AZ 86326-3651
(928) 634-2288
Mailing address
1 N WILLARD ST, COTTONWOOD, AZ 86326-3651
(928) 634-2288
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN083273
AZ
163WS0200X
School Registered Nurse
RN083273
AZ
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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