A Clark Minority Company Llc | |
4615 Marsh Hawk Pl Ponte Vedra Beach FL 32082-3027 | |
(904) 463-1693 | |
Not Available |
Full Name | A Clark Minority Company Llc |
---|---|
Speciality | Counselor - Mental Health |
Location | 4615 Marsh Hawk Pl, Ponte Vedra Beach, Florida |
Authorized Official Name and Position | James Douglas Clark (PRESIDENT/EO) |
Authorized Official Contact | 9044631693 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
A Clark Minority Company Llc 4615 Marsh Hawk Pl Ponte Vedra Beach FL 32082-3027 Ph: (904) 463-1693 | A Clark Minority Company Llc 4615 Marsh Hawk Pl Ponte Vedra Beach FL 32082-3027 Ph: (904) 463-1693 |
NPI Number | 1306385448 |
---|---|
Provider Enumeration Date | 02/22/2017 |
Last Update Date | 02/22/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306385448 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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