Charles Clark
NPI #1629312400 in Crossville, Tennessee
Provider Information
- NPI Number
- 1629312400
- Entity Type
- Individual
- Name
- Charles Clark
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Nov 19, 2012
- Last Updated
- Nov 19, 2012
Practice Location
- Address
- 368 FOURTH ST
- City
- Crossville
- State
- Tennessee
- ZIP Code
- 38555-4309
- Phone
- (423) 622-1551
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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