| Provider / Organization | NPI | Date Certified |
|---|---|---|
| GARY LEE CLARK | 1548876048 | 2020-09-20 |
Gary Lee Clark is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1548876048. Registration indicates Gary Lee Clark is a provider of services with a specialization in Agencies, In Home Supportive Care (In Home Supportive Care, ) (In Home Supportive Care, Agencies)
| Entity Type | Individual |
| Provider Name | Gary Lee Clark |
| Practice Office Address | 71312 WOODS AVE MARTINS FERRY, OH US |
| Practice Office Telephone | 7406333407 |
| Mailing Address | 71312 WOODS AVE MARTINS FERRY, OH 439353104 US |
| Code | Practice | License No State |
|---|---|---|
| 253Z00000X PRIMARY | Agencies In Home Supportive Care In Home Supportive Care In Home Supportive Care Agencies |