Clark, Jonathan
Clark, Jonathan is an individual health care provider with primary practice located at 1214 Highland Lake Cir , Decatur GA 30033-3460. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Clark, Jonathan can be contacted via phone (585) 857-2586.Contact Information
Primary practice address
1214 Highland Lake Cir
Decatur GA 30033-3460
Phone: (585) 857-2586
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer | 2255A2300X | AT003189 | Georgia |
Profile Details
| NPI number | 1720573447 |
|---|---|
| LBN Legal business name | Clark, Jonathan |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2018 |
| Last updated | Jun 25th, 2018 - about 8 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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