Individual
MICHAEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10600 RIVERSIDE DRIVE, CORAL SPRINGS, FL 33071-3307
(954) 812-5661
(954) 812-5661
Mailing address
3192 MERRICK TERRACE, MARGATE, FL 33063
(954) 812-5661
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
1624
FL
Other
Enumeration date
12/08/2017
Last updated
12/08/2017
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