Timothy Dale Clark, CCP

NPI #1831226604 in Gainesville, Florida

Provider Information

NPI Number: 1831226604
Entity Type: Individual
Name: Timothy Dale Clark, CCP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Durable Medical Equipment & Medical Supplies
Credential: CCP
Enumeration Date: Feb 27, 2007
Last Updated: Jul 9, 2007

Practice Location

Address: 1600 SW ARCHER RD
Address 2: SUITE NG-28
City: Gainesville
State: Florida
ZIP Code: 32610-3003
Phone: (352) 665-1209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	Primary

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