Clark Ltc PA

NPI #1104507235 in Bushnell, Florida

Provider Information

NPI Number: 1104507235
Entity Type: Organization
Organization Name: Clark Ltc PA
Primary Specialty: Internal Medicine
Enumeration Date: Jul 31, 2023
Last Updated: Jul 31, 2023

Practice Location

Address: 212 S FLORIDA ST
City: Bushnell
State: Florida
ZIP Code: 33513-6703
Phone: (352) 793-2441

Authorized Official

Name: LOWELL F CLARK, MD
Title: OWNER
Phone: (352) 793-2441

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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