Clark, Michael Dwayne
Clark, Michael Dwayne is an sole proprietor health care provider with primary practice located at 619 Clarence St Apt 5 , Lake Charles LA 70601-5370. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Clark, Michael Dwayne can be contacted via phone (337) 721-8070.Contact Information
Primary practice address
619 Clarence St Apt 5
Lake Charles LA 70601-5370
Phone: (337) 721-8070
Fax: (337) 721-8060
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | Louisiana |
Profile Details
| NPI number | 1063683597 |
|---|---|
| LBN Legal business name | Clark, Michael Dwayne |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 12th, 2008 |
| Last updated | Mar 12th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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