Individual
MR. JAMES HOWARD CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.M.T.
Contact information
Practice address
13629 BALTIMORE AVE, LAUREL, MD 20707-5095
(301) 617-0163
(301) 617-0165
Mailing address
5107 MARTIN DR, OXON HILL, MD 20745-3755
(301) 630-1397
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
M01789
MD
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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