person
Mr. Michael Dwayne Clark
Driver in Lake Charles, Louisiana
NPI 1063683597

Michael Dwayne Clark is a Driver based in Lake Charles, LA. Michael Dwayne Clark practices in Lake Charles, LA. The NPI Number for Michael Dwayne Clark is 1063683597 and holds a License No. (Louisiana).

The current practice location address for Michael Dwayne Clark is 619 Clarence St Apt 5, Lake Charles, LA and can be reached out via phone at 337-721-8070 and via fax at 337-721-8060.

Location: 619 Clarence St Apt 5, Lake Charles, LA, 70601-5370
person
Provider Profile Details
NPI Number
1063683597
Provider Name
Michael Dwayne Clark
Credential
Provider Entity Type
Individual
Gender
Male
Address
619 Clarence St Apt 5, Lake Charles, LA, 70601-5370
Phone Number
337-721-8070
Fax Number
337-721-8060
Provider Enumeration Date
03/12/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
619 Clarence St Apt 5
City
State
Zip
70601-5370
Phone Number
337-721-8070
Fax Number
337-721-8060
person
Provider Business Mailing Address Details
Address
619 Clarence St Apt 5
City
State
Zip
70601-5370
Phone Number
337-721-8070
Fax Number
337-721-8060
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Driver
Speciality
-
Taxonomy
License No.
(Louisiana)
Definition
A person employed to operate a motor vehicle as a carrier of persons or property.
semi-verified symbol
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