Mr. Michael Dwayne Clark
Mr. Michael Dwayne Clark is a Driver in Lake Charles, Louisiana. Practices as a sole proprietor. Licensed in Louisiana.
- Licensed in
- LA
- In the registry since
- 2008
Practice location Address checks out
619 Clarence St Apt 5Lake Charles, LA 70601-5370
Phone: (337) 721-8070
Fax: (337) 721-8060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Driver (primary) | Taxonomy 172A00000X (LA) |
|---|
Record details
| NPI number | 1063683597 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | March 12, 2008 |
| Last updated in NPPES | March 12, 2008 |
| Mailing address | 619 Clarence St Apt 5, Lake Charles, LA 70601-5370 |
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