Individual
TROY MARK CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
MADIAGAN ARMY MEDICAL CENTER,, 9040 JACKSON AVE, ATTN: MCHJ-CLQ-C, TACOMA, WA 98431-1100
(209) 996-8769
Mailing address
MAMC WINDOW SERVICE, 9040 JACKSON AVE., TACOMA, WA 98431-1100
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
325973
TX
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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