MR. Ryan Patrick Clark, PHYSICIAN ASSISTANT
NPI #1013335496 in West Frankfort, Illinois
Provider Information
- NPI Number
- 1013335496
- Entity Type
- Individual
- Name
- MR. Ryan Patrick Clark, PHYSICIAN ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PHYSICIAN ASSISTANT
- Enumeration Date
- Apr 2, 2014
- Last Updated
- Aug 16, 2014
Practice Location
- Address
- 309 W SAINT LOUIS ST
- City
- West Frankfort
- State
- Illinois
- ZIP Code
- 62896-2099
- Phone
- (618) 932-2200
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
| Physician Assistant |
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