Christopher C Clark DO

NPI 1093793341 - Family Medicine - 207Q00000X

NPI Details
NPI 1093793341
Gender Male
Enumeration Date 01/06/2006
Last Updated 05/27/2016
Entity Type Individual
Active Over 10 years ago
Practice Location
2314 SASSAFRAS ST
SUITE 200
ERIE PA, 16502-2722, US
Phone (814) 454-4484
Fax (814) 452-1809
Business Location
1910 SASSAFRAS ST
STE 100
ERIE PA, 16502-2716, US
Phone (814) 454-4484
Fax (814) 860-5050
Toxanomy
Taxonomy Code 207Q00000X
License State Pennsylvania
License Number OS009560L
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According to our database, Christopher C Clark DO NPI is 1093793341, taxonomy code is 207Q00000X and license number is OS009560L, license state is located at Pennsylvania. Christopher C Clark DO physically located at 2314 Sassafras St, Erie PA, 16502-2722. NPI Number Christopher C Clark DO has the Individual type.

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1093793341 NPI number is provided on an as is basis without warranty of any kind. 1093793341 is maintained by the National Plan & Provider Enumeration System. The contents of Christopher C Clark DO are for informational purposes only.