MR. Michael Dwayne Clark
NPI #1063683597 in Lake Charles, Louisiana
Provider Information
- NPI Number
- 1063683597
- Entity Type
- Individual
- Name
- MR. Michael Dwayne Clark
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Driver
- Enumeration Date
- Mar 12, 2008
- Last Updated
- Mar 12, 2008
Practice Location
- Address
- 619 CLARENCE ST APT 5
- City
- Lake Charles
- State
- Louisiana
- ZIP Code
- 70601-5370
- Phone
- (337) 721-8070
Specialties & Taxonomy Codes
| Specialty |
|---|
| Driver |
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