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MR. TIMOTHY PATRICK CLARK
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1659750412
Individual Registrant:MR. TIMOTHY PATRICK CLARK
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
242 N VILLA AVE WILLOWS, CA 95988-2641 US
Tel: 530-934-6585 Fax: 530-934-6592
Tel: 530-934-6585 Fax: 530-934-6592
Contact information for business:
242 N VILLA AVE WILLOWS, CA 95988-2641 US
Tel: 530-934-6585 Fax: 530-934-6592
Tel: 530-934-6585 Fax: 530-934-6592
Registration Information:
NPI: 1659750412
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
