Dennis J Clark PA-C

NPI 1689863805 - Physician Assistant - 363A00000X

NPI Details
NPI 1689863805
Gender Male
Enumeration Date 10/24/2007
Last Updated 01/18/2016
Entity Type Individual
Active Over 9 years ago
Practice Location
1850 E PARK AVE
SUITE 112
STATE COLLEGE PA, 16803-6705, US
Phone (814) 865-3566
Fax (814) 863-7803
Business Location
1850 E PARK AVE
SUITE 112
STATE COLLEGE PA, 16803-6705, US
Phone (814) 865-3566
Fax (814) 768-2344
Toxanomy
Taxonomy Code 363A00000X
License State Pennsylvania
License Number MA052887
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According to our database, Dennis J Clark PA-C NPI is 1689863805, taxonomy code is 363A00000X and license number is MA052887, license state is located at Pennsylvania. Dennis J Clark PA-C physically located at 1850 E Park Ave, State College PA, 16803-6705. NPI Number Dennis J Clark PA-C has the Individual type.

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1689863805 NPI number is provided on an as is basis without warranty of any kind. 1689863805 is maintained by the National Plan & Provider Enumeration System. The contents of Dennis J Clark PA-C are for informational purposes only.