Individual provider · Type 1 NPI
Gregory Clark
Driver · Lakeland, FL
NPI number
1760991012
Active
Practice location
1091 Old South Dr
Lakeland, FL 33811
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver Primary | 172A00000X | None listed |
Driver: A person employed to operate a motor vehicle as a carrier of persons or property.
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About NPI 1760991012
Gregory Clark's National Provider Identifier is 1760991012, issued on Sep 28, 2017. The primary taxonomy on file is Driver (172A00000X), and the practice location is in Lakeland, FL. The record was last updated on Jul 21, 2022.